Abstract
PurposeAnxiety disorders are common. Between 1998 and 2008, in the UK, GP recording of anxiety symptoms increased, but the recording of anxiety disorders decreased. We do not know whether such trends have continued. This study examined recent trends in the recording of anxiety and explored factors that may influence GPs’ coding of anxiety.MethodsWe used data from adults (n = 2,569,153) registered with UK general practices (n = 176) that contributed to the Clinical Practice Research Datalink between 2003 and 2018. Incidence rates and 95% confidence intervals were calculated for recorded anxiety symptoms and diagnoses and were stratified by age and gender. Joinpoint regression was used to estimate the years trends changed. In addition, in-depth interviews were conducted with 15 GPs to explore their views and management of anxiety. Interviews were audio-recorded, transcribed verbatim and analysed thematically.ResultsThe incidence of anxiety symptoms rose from 6.2/1000 person-years at risk (PYAR) in 2003 to 14.7/1000 PYAR in 2018. Between 2003 and 2008, the incidence of anxiety diagnoses fell from 13.2 to 10.1/1000 PYAR; markedly increasing between 2013 and 2018 to 15.3/1000 PYAR. GPs mentioned that they preferred using symptom codes to diagnostic codes to avoid assigning potentially stigmatising or unhelpful labels, and commented on a rise in anxiety in recent years, especially in young adults.ConclusionRecent increases in the recording of both anxiety diagnoses and symptoms may reflect increased presentation to primary care, especially in young adults. There is a clear need to understand the reasons for this, and this knowledge may be critical in the prevention and treatment of anxiety.
Highlights
The aim of this study was to examine trends in the recording of anxiety in UK primary care between 2003 and 2018 using Clinical Practice Research Datalink (CPRD) data and to investigate whether there were differences according to age and gender
The dataset included 176 practices with 2,569,153 eligible patients registered across the 16-year period (2003–2018), and 17.6 million person-years of follow-up (PYFU)
ICD-10 diagnostic codes were used infrequently, with ‘generalised anxiety disorder’ and ‘mixed anxiety and depressive disorder’ each representing less than 2% (n = 3,482/216,126; n = 3,735/216,126) of diagnostic codes
Summary
Within the European Union, approximately 38.2% of the population experience a mental disorder each year, of which anxiety is the most prevalent (14%) [1]. In UK general practice, the prevalence (7.2%) and incidence (9.7 per 1000 person-years) of anxiety disorders is high [2]. Others have reported an increase in symptom codes for anxiety and depression combined [4] and a recent increase in anxiety codes (1998–2018)[5]. Slee et al [5] focused on generalised anxiety disorder (GAD) and combined symptom and diagnosis codes. No data are available on whether GP recording of presentations of anxiety in UK primary care has changed in recent years
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
