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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Addis Ababa University


Introduction: Anxiety Disorders are a group of disorders that have a core symptom of excessive fear and anxiety and associated behavioral symptoms. It is a condition that can be experienced by anyone but it needs intervention when symptoms become excessively distressing or disabling, or reduce 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 million prevalence 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 for Clinical 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 the use of Antidepressant medications. The treatment gap for mental illness throughout the world is universally large. Despite the enormous burden Anxiety disorders pose to our health care system there 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 anxiety received 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 Anbessa specialized hospital patients that visited the OPD from Hamle 1, 2010 E.C to Hamle 30, 2013 EC. 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 and descriptive analysis was done. Result: This study found the commonest diagnosis to be GAD (58.5%) and the second commonest diagnosis was Panic Disorder (32.7%). The study found that there is a high psychiatric 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 were in the study 32 (32.6%) were offered only medications while 18 (18.4%) of patients were offered only psychotherapy. Both of these modalities were offered in combination in 25 (25.5%) of the cases. 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 increase the likelihood of treatment engagement in the study.



Anxiety Disorders, Patients