This excellent qualitative interview study carried out by Archer et al1 critically assesses GP and patient perspectives on diagnosing anxiety disorders versus ruling anxiety as a symptom. Anxiety can be an extremely debilitating condition and needs to be managed with care. From my clinical experience, the authors’ point that patients find a long-term anxiety disorder harder to cope with compared with depression is very convincing.
As a GP, I have fallen prey to using anxiety symptom codes as opposed to diagnostic anxiety disorder codes in my own practice. Many of the GPs’ views from this study resonated with my own reasoning for this. Conversely, it was helpful to see that, from the patient perspective, having a proper diagnosis of anxiety helped them to come to terms with and engage with treatment better. Overall, my realisation is that I will need to adjust my practice more to the patient in front of me and always have the diagnosis of anxiety disorders in mind.
One point that the study did not touch upon, but I would find interesting to read about in the future, is the effect of the COVID-19 pandemic on the perspectives of GPs and patients on diagnosis of anxiety disorders. There is no question that the mental health impact of the pandemic has been tremendous2 and the prevalence of anxiety and depression in the population has changed. Would this consequently affect the views of GPs and patients in this study?
In my day-to-day practice, I have been encountering more and more patients with symptoms pertaining to anxiety disorders. Would the pandemic compel many patients and GPs to shelve these symptoms to be a mere ‘side effect’ of the pandemic? Would this consequently lead to GPs using anxiety symptom codes more often? Nevertheless, the value of providing accurate diagnoses concerning mental health is more important now than ever.
- © British Journal of General Practice 2021
