Pharmacotherapy of anxiety disorders in German-speaking countries: current status and changes between 1994 and 2011

Abstract

Over the past years, international treatment guidelines have been established for the treatment of anxiety disorders. Nevertheless, little is known as to whether the actual inpatient treatment follows these guidelines. The main goal of this study was to answer the question whether patients with anxiety disorder are treated according to treatment guidelines. A total of 2,573 psychiatric inpatients with the diagnosis of anxiety disorder (920 men, 1,653 women) were identified on the basis of the data of the international drug safety programme in psychiatry AMSP. Of these patients, 25.3% presented with phobia, 26.6% with panic disorder, 18.7% with generalized anxiety disorder (GAD), and 29.4% with other diagnoses of anxiety. In all of the patients, 12.7% did not receive any psychotropic medication and 22.9% were not treated with antidepressants. Only 59.3% of patients with GAD, 73.9% of patients with panic disorder, and 52.1% of patients with phobia were treated according to diagnostic guidelines. The majority (60.3%) of all patients received one or two psychotropic drugs, and only 3.7% received five or more psychotropic drugs. In two groups of patients (one group with phobia and one with panic disorder), the annual prescription rate of antidepressants significantly increased over time. The prescription rate for anticonvulsants in patients with GAD increased from 0% in 1997 to 41.7% in 2011, and for antipsychotics, from 40.7% in 1997 to 47.2% in 2011. In particular, patients with GAD were commonly treated with antipsychotics.

Psychiatrists’ self-stigma, the DGPPN guideline for psychosocial interventions, and contemporary treatment strategies

“…Anyhow, there still is a need for further context-specific research in severe mental illness. Holl et al [3], again, focus on the abidance of recommendations on pharmacological treatment of internationally published treatment guidelines of anxiety disorders. Screening data of 2573 psychiatric inpatients with the respective diagnosis (phobia, panic disorder, generalized anxiety disorder, other diagnosis of anxiety) filed in the international drug safety program in psychiatry (AMSP), the authors found that all diagnostic groups were only partially treated in accordance with international treatment guidelines, for which reason they see a strong need for a better implementation of recommendations in primary and secondary care.…”