چکیده (انگلیسی):

Purpose:Generalized Anxiety Disorder (GAD) is a common mental disorder in the primary care setting, marked by
persistent anxiety and worries. The aims of this study were to: 1) examine mental health services utilisation in a
large sample of primary care patients; 2) explore detection of GAD and minimal standards for pharmacological and
psychological treatment adequacy based on recommendation from clinical practice guidelines; 3) examine
correlates of treatment adequacy, i.e. predisposing, enabling and needs factors according to the Behavioural Model
of Health Care Use.
Methods:A sample of 373 adults meeting DSM-IV criteria for Generalized Anxiety Disorder in the past 12 months
took part in this study. Data were drawn from the“Dialogue” project, a large primary care study conducted in 67
primary care clinics in Quebec, Canada. Following a mental health screening in medical clinics (n = 14833), patients
at risk of anxiety or depression completed the Composite International Diagnostic Interview-Simplified (CIDIS).
Multilevel logistic regression models were developed to examine correlates of treatment adequacy for
pharmacological and psychological treatments.
Results:Results indicate that 52.5 % of participants were recognized as having GAD by a healthcare professional in
the past 12 months, and 36.2 % of the sample received a pharmacological (24.4 %) and/or psychological treatment
(19.2 %) meeting indicators based on clinical practice guidelines recommendations. The detection of GAD by a
health professional and the presence of comorbid depression were associated with overall treatment adequacy.
Conclusions:This study suggests that further efforts towards GAD detection could lead to an increase in the
delivery of evidence-based treatments. Key targets for improvement in treatment adequacy include regular follow
up of patients with a GAD medication and access to psychotherapy from the primary care setting.