GPs' and patients' views on the value of diagnosing anxiety disorders in primary care: a qualitative interview study

Background In the UK between 1998 and 2008, GPs' recording or anxiety symptoms increased, but their recording of anxiety disorders decreased. The reason for this decline is not dear, nor are the treatment implications for primary care patients. Aim To understand GPs and patients views on the value of diagnosing anxiety disorders in primary rare. Design and setting In-depth interviews were conducted with 15 GPs and 70 patients, purposively sampled from GP practices in Bristol and the surrounding areas. Method Interviews were held either in person or by telephone. A topic guide was used to ensure consistency across the interviews. The interviews were audio-recorded, transcribed verbatim, and analysed thematically. Results GPs reported preferring to use symptom rather than diagnostic codes in order to avoid assigning potentially stigmatising labels, and because they fell diagnostic codes could encourage some patients to adopt a 'sick role'. In addition, their decision to use a diagnostic code depended on symptom severity and chronicity. and these were hard to establish in a time limited clinical consultation. In contrast, patients commented that receiving a diagnosis helped them to understand their symptoms, and encouraged them to engage with treatment. Conclusion GPS may be reluctant to diagnose an anxiety disordor, but patients can find a diagnosis helpful in terms of understanding their symptoms and the need for treatment. As limited consultation time can discourage discussions between GPs and patients, followup appointments and continuity of care may be particularly important for the management of anxiety in primary care.