Review ArticleClinical Review
Brief Intervention for Anxiety in Primary Care Patients
Peter Roy-Byrne, Jason P. Veitengruber, Alexander Bystritsky, Mark J. Edlund, Greer Sullivan, Michelle G. Craske, Stacy Shaw Welch, Raphael Rose and Murray B. Stein
The Journal of the American Board of Family
Medicine March 2009, 22 (2) 175-186; DOI: https://doi.org/10.3122/jabfm.2009.02.080078
Peter Roy-Byrne
Department of Psychiatry and Behavioral Sciences (PRB, JPV, SSW), University of Washington School of Medicine, Harborview Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations (CHAMMP), Seattle
MDJason P. Veitengruber
Department of Psychiatry and Behavioral Sciences (PRB, JPV, SSW), University of Washington School of Medicine, Harborview Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations (CHAMMP), Seattle
MDAlexander Bystritsky
Department of Psychiatry and Biobehavioral Sciences (AB), University of California, Los Angeles
MDMark J. Edlund
Department of Psychiatry (MJE, GS), University of Arkansas for Medical Sciences, Little Rock
MD, PhDGreer Sullivan
Department of Psychiatry (MJE, GS), University of Arkansas for Medical Sciences, Little Rock
MDMichelle G. Craske
Department of Psychology (MGC, RR), University of California, Los Angeles
PhDStacy Shaw Welch
Department of Psychiatry and Behavioral Sciences (PRB, JPV, SSW), University of Washington School of Medicine, Harborview Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations (CHAMMP), Seattle
PhDRaphael Rose
Department of Psychology (MGC, RR), University of California, Los Angeles
PhDMurray B. Stein
Department of Psychiatry (MBS), University of California, San Diego
MD, MPH
References
- ↵Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 617–27.
- ↵Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC. Twelve-month use of mental health services in the United States. Results from the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 629–40.
- ↵Stein MB, Roy-Byrne PP, Craske MG, et al. Functional impact and health utility of anxiety disorders in primary care outpatients. Med Care 2005; 43: 1164–70.
- ↵Katon W, Roy-Byrne P, Russo J, Cowley D. Cost-effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder. Arch Gen Psychiatry 2002; 59: 1098–104.
- ↵Stein MB, Sherbourne CD, Craske MG, et al. Quality of care for primary care patients with anxiety disorders. Am J Psychiatry 2004; 161: 2230–7.
- ↵Nisenson LG, Pepper CM, Schwenk TL, Coyne JC. The nature and prevalence of anxiety disorders in primary care. Gen Hosp Psychiatry 1998; 20: 21–8.
- ↵Ormel J, Koeter MW, van den Brink W, van de Willige G. Recognition, management, and course of anxiety and depression in general practice. Arch Gen Psychiatry 1991; 48: 700–6.
- ↵Kroenke K, Jackson JL, Chamberlin J. Depressive and anxiety disorders in patients presenting with physical complaints: clinical predictors and outcome. Am J Med 1997; 103: 339–47.
- ↵Mojtabai R, Olfson M, Mechanic D. Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Arch Gen Psychiatry 2002; 59: 77–84.
- ↵Stein MB, McQuaid JR, Pedrelli P, Lenox R, McCahill ME. Posttraumatic stress disorder in the primary care medical setting. Gen Hosp Psychiatry 2000; 22: 261–9.
- Sherbourne CD, Jackson CA, Meredith LS, Camp P, Wells KB. Prevalence of comorbid anxiety diorders in primary care outpatients. Arch Fam Med 1996; 5: 27–34.
- Spitzer RL, Kroenke K, Williams JBW. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA 1999; 282: 1737–44.
- Kroenke K, Spitzer RL, Williams JB, et al. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med 2007; 146: 317–25.
- ↵Sullivan G, Craske MG, Sherbourne C, et al. Design of the Coordinated Anxiety Learning and Management (CALM) study: innovations in collaborative care for anxiety disorders. Gen Hosp Psychiatry 2007; 29: 379–87.
- ↵Miller WR, Rollnick S. Motivational interviewing: preparing people to change addictive behavior. New York: Guilford Press; 1991.
- ↵
- ↵Means-Christensen A, Sherbourne CD, Roy-Byrne PP, Craske MG, Stein MB. Using five questions to screen for five common mental disorders in primary care: the anxiety and depression detector (ADD). Gen Hosp Psychiatry 2006; 28: 108–18.
- ↵U.S. PSTF: Screening for Depression
- ↵Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 1997; 12: 439–45.
- ↵Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res 2007; 31: 1208–17.
- ↵Butt Z, Wagner LI, Beaumont JL, et al. Use of a single-item screening tool to detect clinically significant fatigue, pain, distress, and anorexia in ambulatory cancer practice. J Pain Symptom Manage 2008; 35: 20–30.
- ↵Sareen J, Cox BJ, Afifi TO, et al. Anxiety disorders and risk for suicidal ideation and suicide attempts: a population-based longitudinal study of adults. Arch Gen Psychiatry 2005; 62: 1249–57.
- ↵Linehan MM, Goodstein JL, Nielsen SL, Chiles JA. Reasons for staying alive when you are thinking of killing yourself: the reasons for living inventory. J Consult Clin Psychol 1983; 51: 276–86.
- ↵Simon NM, Otto MW, Wisniewski SR, et al. Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry 2004; 161: 2222–9.
- ↵Hirschfeld RM, Williams JB, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry 2000; 157: 1873–5.
- ↵
- ↵Lowe B, Decker O, Muller S, et al. Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Med Care 2008; 46: 266–74.
- ↵Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166: 1092–7.
- ↵
- ↵
- ↵Katon W, Von Korff M, Lin E, Simon G. Rethinking practitioner roles in chronic illness: the specialist, primary care physician, and the practice nurse. Gen Hosp Psychiatry 2001; 23: 138–44.
- ↵Trivedi MH, Rush AJ, Wisniewski SR, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry 2006; 163: 28–40.
- ↵Nierenberg AA, DeCecco LM. Definitions of antidepressant treatment response, remission, nonresponse, partial response, and other relevant outcomes: a focus on treatment-resistant depression. J Clin Psychiatry 2001; 62(suppl 16): 5–9.
- ↵Williams SL, Kinney PJ, Falbo J. Generalization of therapeutic changes in agoraphobia: the role of perceived self-efficacy. J Consult Clin Psychol 1989; 57: 436–42.
- Safren SA, Heimberg RG, Juster HR. Clients’ expectancies and their relationship to pretreatment symptomatology and outcome of cognitive-behavioral group treatment for social phobia. J Consult Clin Psychol 1997; 65: 694–8.
- Grilo CM, Money R, Barlow DH, et al. Pretreatment patient factors predicting attrition from a multicenter randomized controlled treatment study for panic disorder. Compr Psychiatry 1998; 39: 323–32.
- ↵Miller WR. Motivational interviewing: research, practice, and puzzles. Addict Behav 1996; 21: 835–42.
- Miller WR, Baca C, Compton WM, et al. Addressing substance abuse in health care settings. Alcohol Clin Exp Res 2006; 30: 292–302.
- ↵Miller WR, Rollnick S. Motivational interviewing: Preparing people for change. 2nd edition. New York: Guilford Press; 2002.
- ↵Westra H, Dozois D. Preparing clients for cognitive behavior theray: a randomized pilot study of motivational interviewing for anxiety. Cognit Ther Res 2006; 30: 481–98.
- ↵
- ↵Barlow DH. Anxiety and its disorders: the nature and treatment of anxiety and panic. New York: Guilford Press; 2002.
- ↵Swinson RP, Soulios C, Cox BJ, Kuch K. Brief treatment of emergency room patients with panic attacks. Am J Psychiatry 1992; 149: 944–6.
- ↵Craske MG. Anxiety disorders: psychological approaches to theory and treatment. Boulder (CO): Westview Press; 1999.
- ↵Beck A, Emery G, Greenberg R. Anxiety disorders and phobias: a cognitive perspective. New York: Basic Books; 1985.
- ↵Ost L, Westling B. Applied relaxation vs cognitive therapy in the treatment of panic disorder. Behav Res Ther 1995; 33: 145–8.
- ↵Garssen B, Ruiter CD, Dyck RV, et al. Will hyperventilation syndrome survive: a responder to Ley. Clinical Psychology Review 1993; 13: 683–90.
- ↵Broman-Fulks JJ, Storey KM. Evaluation of a brief aerobic exercise intervention for high anxiety sensitivity. Anxiety Stress Coping 2008; 21: 117–28.
- ↵Strohle A, Feller C, Onken M, Godemann F, Heinz A, Dimeo F. The acute antipanic activity of aerobic exercise. Am J Psychiatry 2005; 162: 2376–8.
- ↵Roy-Byrne PP, Cowley D. Pharamcologic treatments for panic disorder, generalized anxiety disorders, specific phobia and social anxiety disorders. In: Nathan P, Gorman J, eds. A guide to treatments that work, 3rd edition. New York: Oxford University Press; 2007.
- ↵Stein MB. Anxiety disorders: somatic treatment. In: Sadock BJ, Sadock VA, eds. Comprehensive textbook of psychiatry, 8th edition. Baltimore (MD): Lippincott Williams & Wilkins; 2004.
- ↵Kroenke K, West SL, Swindle R, et al. Similar effectiveness of paroxetine, fluoxetine, and sertraline in primary care: a randomized trial. JAMA 2001; 286: 2947–55.
- ↵Fava M, Rosenbaum JF, Hoog SL, Tepner RG, Kopp JB, Nilsson ME. Fluoxetine versus sertraline and paroxetine in major depression: tolerability and efficacy in anxious depression. J Affect Disord 2000; 59: 119–26.
- ↵
- ↵Goddard AW, Brouette T, Almai A, Jetty P, Woods SW, Charney D. Early coadministration of clonazepam with sertraline for panic disorder. Arch Gen Psychiatry 2001; 58: 681–6.
- ↵Rickels K, Schweizer E, Case WG, Greenblatt DJ. Long-term therapeutic use of benzodiazepines. I. Effects of abrupt discontinuation. Arch Gen Psychiatry 1990; 47: 899–907.
- Rickels K, Schweizer E, Csanalosi I, Case WG, Chung H. Long-term treatment of anxiety and risk of withdrawal. Prospective comparison of clorazepate and buspirone. Arch Gen Psychiatry 1988; 45: 444–50.
- Rickels K, Schweizer E, Weiss S, Zavodnick S. Maintenance drug treatment for panic disorder. II. Short- and long-term outcome after drug taper. Arch Gen Psychiatry 1993; 50: 61–8.
- ↵
- ↵Bystritsky A. Treatment-resistant anxiety disorders. Mol Psychiatry 2006; 11: 805–14.
- ↵Mellman TA, Clark RE, Peacock WJ. Prescribing patterns for patients with posttraumatic stress disorder. Psychiatr Serv 2003; 54: 1618–21.
- ↵Stewart SA. The effects of benzodiazepines on cognition. J Clin Psychiatry 2005; 66(suppl 2): 9–13.
- ↵Pande AC, Pollack MH, Crockatt J, et al. Placebo-controlled study of gabapentin treatment of panic disorder. J Clin Psychopharmacol 2000; 20: 467–71.
- ↵Pande AC, Davidson JR, Jefferson JW, et al. Treatment of social phobia with gabapentin: a placebo-controlled study. J Clin Psychopharmacol 1999; 19: 341–8.
- ↵Feltner DE, Crockatt JG, Dubovsky SJ, et al. A randomized, double-blind, placebo-controlled, fixed-dose, multicenter study of pregabalin in patients with generalized anxiety disorder. J Clin Psychopharmacol 2003; 23: 240–9.
- ↵Fava M, Rush AJ, Wisniewski SR, et al. A comparison of mirtazapine and nortriptyline following two consecutive failed medication treatments for depressed outpatients: a STAR*D report. Am J Psychiatry 2006; 163: 1161–72.
- McGrath PJ, Stewart JW, Fava M, et al. Tranylcypromine versus venlafaxine plus mirtazapine following three failed antidepressant medication trials for depression: a STAR*D report. Am J Psychiatry 2006; 163: 1531–41; quiz 1666.
- Rush AJ. STAR*D: what have we learned? Am J Psychiatry 2007; 164: 201–4.
- Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry 2006; 163: 1905–17.
- ↵Stein MB, Kline NA, Matloff JL. Adjunctive olanzapine for SSRI-resistant combat-related PTSD: a double-blind, placebo-controlled study. Am J Psychiatry 2002; 159: 1777–9.
- Pollack MH, Simon NM, Zalta AK, et al. Olanzapine augmentation of fluoxetine for refractory generalized anxiety disorder: a placebo controlled study. Biol Psychiatry 2006; 59: 211–5.
- Rothbaum BO, Killeen TK, Davidson JR, Brady KT, Connor KM, Heekin MH. Placebo-controlled trial of risperidone augmentation for selective serotonin reuptake inhibitor-resistant civilian posttraumatic stress disorder. J Clin Psychiatry 2008; 69: 520–5.
In this issue
Brief Intervention for Anxiety in Primary Care Patients
Peter Roy-Byrne, Jason P. Veitengruber, Alexander Bystritsky, Mark J. Edlund, Greer Sullivan, Michelle G. Craske, Stacy Shaw Welch, Raphael Rose, Murray B. Stein
The Journal of the American Board of Family
Medicine Mar 2009, 22 (2) 175-186; DOI: 10.3122/jabfm.2009.02.080078
Brief Intervention for Anxiety in Primary Care Patients
Peter Roy-Byrne, Jason P. Veitengruber, Alexander Bystritsky, Mark J. Edlund, Greer Sullivan, Michelle G. Craske, Stacy Shaw Welch, Raphael Rose, Murray B. Stein
The Journal of the American Board of Family
Medicine Mar 2009, 22 (2) 175-186; DOI: 10.3122/jabfm.2009.02.080078
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