Abstract
BackgroundAnxiety disorders are the most prevalent class of lifetime mental disorders according to South African research. However, little is known about the prevalence of factors that might complicate treatment among adults in a psychiatric outpatient setting.AimTo explore the psychiatric comorbidities and psychosocial stressors among a population of adults treated for anxiety disorders at the outpatient unit of a tertiary psychiatric facility in Bloemfontein.MethodsIn this retrospective cross-sectional study, clinical files of all mental healthcare users receiving treatment were reviewed to identify those with a current or previous diagnosis of one or more of the following anxiety disorders: generalised anxiety disorder (GAD), panic disorder, social anxiety disorder (SAD) and agoraphobia.ResultsOf the 650 available records, 103 (15.8%) included at least one anxiety disorder. Of those, 65.1% had GAD, 34.0% had panic disorder and 29.1% had SAD. Agoraphobia was diagnosed in 14.6% of patients almost exclusively as comorbid with panic disorder. Additional psychiatric disorders were present for 98.1% of patients and 36.9% had multiple anxiety disorders. The patients had a history of relational problems (64.1%), educational and occupational stressors (55.3%), abuse and neglect (28.2%), other problems related to the social environment (24.3%) and self-harm (23.3%).ConclusionClinical practice should take the high rates of comorbidity into account and the importance of integrated substance-related interventions in mental healthcare settings is clear. Diagnostic practices regarding agoraphobia without panic, and the comorbidity of anxiety and personality disorders should receive further attention. Clinicians should be aware of the potential impact of the frequently reported psychosocial stressors.
Highlights
As part of the South African Stress and Health (SASH) study, which investigated the lifetime prevalence of common mental disorders, anxiety disorders were found to be the most prevalent class of lifetime mental disorders (15.8%), followed by substance use disorders (13.3%) and mood disorders (9.8%).[1]
A large proportion of patients diagnosed with an anxiety disorder (36.9%) presented with multiple anxiety disorders, the most common combinations being generalised anxiety disorder (GAD) with social anxiety disorder (SAD) (11.7%) and GAD with panic disorder (9.7%)
The only significant difference between the three main single anxiety diagnosis patients was regarding other problems related to the social environment (p = 0.02), which occurred in nearly half of the SAD group, a quarter of the GAD group and none of the panic disorder group
Summary
As part of the South African Stress and Health (SASH) study, which investigated the lifetime prevalence of common mental disorders, anxiety disorders were found to be the most prevalent class of lifetime mental disorders (15.8%), followed by substance use disorders (13.3%) and mood disorders (9.8%).[1]. Anxiety disorders had the highest 12-month prevalence (8.1%) of all psychiatric disorders, and the Free State’s provincial lifetime prevalence of anxiety disorders was significantly higher than countrywide rates. The presence of severe depression or anxiety disorders has been associated with significantly reduced earnings among employed and unemployed South African adults.[2] Data from the SASH study on the association of mental and physical disorders with days out-of-role (i.e. unable to work or carry out day-to-day activities) indicated that the highest reported days out-of-role were associated with mental disorders (28.2 for anxiety and 27.2 for depression), followed by physical disorders (24.7 for arthritis and 21.7 for pain). Anxiety disorders are the most prevalent class of lifetime mental disorders according to South African research. Little is known about the prevalence of factors that might complicate treatment among adults in a psychiatric outpatient setting
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Schedule a callMore From: The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa
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