Clinical Care of Patients with Anxiety Disorders Receiving Care at Psychiatric Outpatient Clinic at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Chart Review
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Date
2022-02
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Addis Ababa University
Abstract
Introduction: Anxiety Disorders are a group of disorders that have a core symptom of excessivefear and anxiety and associated behavioral symptoms. It is a condition that can be experienced byanyone but it needs intervention when symptoms become excessively distressing or disabling, orreduce quality of life.
Background: Anxiety Disorders constitute the leading prevalent mental disorders in the world.Globally, there are around 45.82 million incidences of anxiety disorders and 301.39 millionprevalence rate of Anxiety Disorders. The DALYs as estimated by the GBD in 2019 was estimated to be around 28 million years. In Ethiopia, it is estimated that the lifetime prevalence of anxiety disorders is around 7.5 % in a study done in Addis Ababa. National Institute forClinical Excellence (NICE) guidelines recommend the use of psychological interventions in anxiety spectrum disorders. The most evidence is for Cognitive Behavioral Therapy (CBT)which has the highest empirical evidence whereas the most evidence for pharmacotherapy is theuse of Antidepressant medications. The treatment gap for mental illness throughout the world isuniversally large. Despite the enormous burden Anxiety disorders pose to our health care systemthere hasn’t been much evaluation done regarding the quality of care mental health services.
Objective: the objective of the study was to evaluate the types of care patients with anxietyreceived including the psychological and pharmacological treatment provided to them. This study also aims to determine the level of patient engagement to treatment and to determine the associated factors.
Method: A Retrospective chart (EMR) review was done to explore the socio-demographic characteristics, Clinical Evaluation, Treatment modalities offered and Treatment Engagement of patients with Anxiety disorders in psychiatric outpatient department of Tikur Anbessaspecialized hospital patients that visited the OPD from Hamle 1, 2010 E.C to Hamle 30, 2013EC. Once the data was obtained it was exported to Excel spreadsheet and it was cleaned and checked for errors and missing variables, and then it was exported to SPSS version 26 anddescriptive analysis was done.
Result: This study found the commonest diagnosis to be GAD (58.5%) and the secondcommonest diagnosis was Panic Disorder (32.7%). The study found that there is a highpsychiatric comorbidity of anxiety disorders with MDD and other anxiety disorders accounting for 33.3% and 28.3% respectively. Out of the other anxiety disorders, a higher co-occurrence between panic disorders and generalized anxiety disorders was seen. From the 98 cases that werein the study 32 (32.6%) were offered only medications while 18 (18.4%) of patients were offeredonly psychotherapy. Both of these modalities were offered in combination in 25 (25.5%) of thecases. Neither medication nor psychotherapy was offered for 23(23.5%) of the cases in the study.Psychoeducation, psychotherapy referral and prescription of medication were found to increasethe likelihood of treatment engagement in the study.
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Keywords
Anxiety Disorders, Patients