What Purpose Are These Guidelines Designed For?
Along with depression and eating disorders, anxiety is one of the most common mental health problems. It can often be treated effectively in primary care. GPs often see anxiety, mixed anxiety
and depressive disorders which may be associated with high levels of disability.
These guidelines are designed to assist GPs and other practitioners to assess and manage this
disorder effectively in the Primary Care setting.
Anxiety Epidemiology
In primary care, anxiety neurosis and phobias were once thought to represent the commonest psychiatric disorder. They are now believed to take second palce to depressive and adjustment
disorder and are diagnosed clinically in almost 80% of those with conspicuous psychiatric morbidity. Epidemiological studies are difficult in this area.
Point prevalence data indicates that at any particular time it is likely that about 3% of the population
will be suffering from panic disorder, 6% from agoraphobia, 3% from generalised anxiety disorder,
2.5% from specific phobias and 1.5% from social disorders. The female: male sex ratio has been
found for phobias to be 2:1, and for generalised anxiety disorder 3.5:1.
How Were Users & Carers Consulted?
• Engagement of Salford Mental Health Forum (User group) in development and endorsement of the
 guidelines.
What Evidence And/Or National Guidance Was Used In Developing The Guidelines?
- Kessler, D., Lloyd, K., Lewis, G. & Gray, D. (1999). Cross-sectional study of symptoms attribution
and recognition of depression and anxiety in primary care. British Medical Journal 318, 436-440.
- Roth, A. & Fonagy, P. (1996). What works for whom? Guildford Press, New York.
- Oakley Browne, M.A. Antidepressant drugs relieve symptoms of obsessive-compulsive disorder.
Evidence-based Medicine 1, 82 (1996).
- Committee of Safety Medicines. Prescribing of Benzodiazepines. Current Problems (1998).
- HM Government. National Service Framework for Mental Health:
Modern Standards & Service Models (HMSO, London, 1999).
- British National Formulary.
What Aspects Will Be Monitored & Measured To Assess Impact In Primary Care?
• prescribing practices for anti-depressant medication.
• retrospective analysis of referrals to specialist services.
Who designed these guidelines?
Core members of mental health guidelines development group. (See introduction section).
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