Access to psychotherapy for primary care patients with anxiety disorders.
Bibliographic record
Abstract
Anxiety disorders are common mental health problems in the community, and primary care has a predominant role in the diagnosis and treatment of these conditions. While most patients are treated with pharmacotherapy, clinical practice guidelines recommendations also comprise psychotherapy interventions. The aims of this study were: (a) to examine access to psychotherapy for anxiety disorders in a sample of primary care patients; and (b) to examine individual factors associated with access to psychotherapy. Data were drawn from the Dialogue project, a large primary care study conducted in 67 primary care clinics. After a mental health screening, patients with anxiety or depressive symptoms were invited to participate in a telephone/Web structured interview to assess Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) anxiety and depressive disorders, as well as service utilization. In our sample, a total of 740 adults met DSM-IV criteria for panic disorder, generalized anxiety disorder or social anxiety disorder in the past 12 months. Nearly half of the respondents with anxiety disorders had received a form of psychotherapy or counselling in the past 12 months, and 20% of respondents reported at least 12 sessions with the same health care professional. Individual correlates of access to psychotherapy, based on a logistic regression model, included being a woman, less than 60 years old, a university education level, supplementary insurance and having a comorbid depression episode. These findings emphasize the need to improve access to psychotherapy for individuals with anxiety disorders in primary care and to reduce disparities in access to psychotherapy.Keywords: anxiety disorder, primary care, evidence-based treatments, cognitive behavior therapy, service utilizationResumeLes troubles anxieux sont des problemes de sante mentale courants, et le secteur des soins primaires a un role important a jouer dans le diagnostic et le traitement de ces conditions. Si la plupart des patients sont traites au moyen de la pharmacotherapie, les lignes directrices de la pratique clinique recommandent aussi la psychotherapie. Les objectifs de cette etude etaient les suivants : a) examiner l'acces a la psychotherapie pour les troubles anxieux parmi un echantillon de patients de fournisseurs de soins primaires; b) examiner les facteurs individuels associes a l'acces a la psychotherapie. Des donnees ont ete tirees du projet Dialogue, une vaste etude sur les soins primaires realisee dans 67 cliniques. Apres un examen de depistage de troubles mentaux, les patients ayant des symptomes d'anxiete ou de depression ont ete invites a participer a une entrevue structuree par telephone ou basee sur le Web en vue d'evaluer les troubles anxieux et depressifs selon le Manuel diagnostique et statistique des troubles mentaux - 4e edition (DSM-IV), de meme que leur recours aux services. Dans notre echantillon, 740 adultes ont presente, au cours des 12 derniers mois, les criteres precises dans le DSM-IV pour le trouble panique, le trouble d'anxiete generalise ou la phobie sociale. Pres de la moitie des repondants ayant des troubles anxieux avaient recu une forme de psychotherapie ou du counseling au cours des 12 derniers mois, et 20 % des repondants ont dit avoir assiste a au moins 12 rencontres avec le meme professionnel de la sante. Les correlats individuels de l'acces a la psychotherapie, fondes sur un modele de regression logique, sont les suivants : etre une femme, etre âge de moins de 60 ans, avoir une education universitaire, posseder une assurance de soins complementaires et avoir eu un episode de depression comorbide. Ces resultats mettent en relief la necessite d'ameliorer l'acces des gens souffrant de troubles anxieux a la psychotherapie au sein du secteur des soins primaires et de reduire l'ecart dans l'acces a la psychotherapie.Mots-cles : trouble anxieux, soins primaires, traitement base sur des donnees probantes, therapie cognitivo-comportementale, utilisation des services. …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".