CLINICAL AND EPIDEMIOLOGIC-STUDY OF GENERAL ANXIETY DISORDERS IN GENERAL-PRACTICE

Recent studies have shown that 16 to 43 % of general practice attenders express minor psychiatric disorders (Barrett et al. 1988). The present survey was carried out among a sample of 1 177 patients seen by 121 private general practitioners through out France. Its purpose was: to rate the point-prevalence of general anxiety disorders (GAD) according to DSM III criteria, to evaluate sociodemographic and clinical status of patients with a GAD, to identify the anxiety symptoms that were the most frequently exhibited in a primary-care practice. 181 patients (15.4 %) were assessed a GAD diagnosis. 217 patients (18.4 %) were assessed a <<secondary anxiety>> diagnosis ie anxiety associated with an affective disorder (14.8 %), phobia (2.5 %), panic disorder (1 %). Patients with a GAD were predominantly female, between the age of 35-50 years. They tended to be widowed, separated or divorced and of an average socio-economic level. They also had more previous psychiatric disorders. The GAD appeared to start at the middle age of the life (36 years), to be chronic (lasting over one year) in half of the cases, and to be recurrent. The somatic expression of anxiety was frequent (21 %) but 34 % of the patients expressed directly their psychological distress. Psychotropic drugs were prescribed to 75 % of the subjects. Benzodiazepines were prescribed in 34 % of the cases. More surprisingly, antidepressive drugs were prescribed more often when a GAD was diagnosed. This results confirm the high point-prevalence rate of anxiety disorders in general practice. Some psychological and social factors appear to be similar for patients with a GAD and patients with another type of anxiety disorder.