Abstract
Various guidelines have been issued to doctors concerning the treatment of anxiety in primary care and particularly on the use of benzodiazepines. Little has been reported about how this advice has influenced doctors' opinions and practice. This paper describes results of interviews with 15 general practitioners and 15 general practitioner trainees on their management of anxiety problems. Most respondents admitted prescribing benzodiazepines for anxiety but reported doing so only in cases of severe distress and for short periods of time. Trainees appeared more cautious in their use of benzodiazepines than the experienced practitioners. Most doctors agreed that counselling could be as effective as benzodiazepines in treating moderate anxiety but several respondents felt it too demanding of their time. Two-thirds of doctors were in favour of employing counsellors in general practice though many foresaw practical difficulties in doing so. Increased availability of clinical psychology services was the development which most respondents felt would improve their management of anxiety problems in primary care.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ashton H. Benzodiazepine withdrawal: an unfinished story. Br Med J (Clin Res Ed) 1984 Apr 14;288(6424):1135–1140. doi: 10.1136/bmj.288.6424.1135. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Catalan J., Gath D. H. Benzodiazepines in general practice: time for a decision. Br Med J (Clin Res Ed) 1985 May 11;290(6479):1374–1376. doi: 10.1136/bmj.290.6479.1374. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Catalan J., Gath D., Edmonds G., Ennis J. The effects of non-prescribing of anxiolytics in general practice. I. Controlled evaluation of psychiatric and social outcome. Br J Psychiatry. 1984 Jun;144:593–602. doi: 10.1192/bjp.144.6.593. [DOI] [PubMed] [Google Scholar]
- Corney R. H. Counselling in general practice--does it work? Discussion paper. J R Soc Med. 1990 Apr;83(4):253–257. doi: 10.1177/014107689008300416. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dunn G. Patterns of psychiatric diagnosis in general practice: the Second National Morbidity Survey. Psychol Med. 1986 Aug;16(3):573–581. doi: 10.1017/s0033291700010333. [DOI] [PubMed] [Google Scholar]
- Fleischhacker W. W. Benzodiazepines in anxiety. Lancet. 1988 Jan 30;1(8579):242–242. doi: 10.1016/s0140-6736(88)91092-6. [DOI] [PubMed] [Google Scholar]
- Johnstone E. C., Owens D. G., Frith C. D., McPherson K., Dowie C., Riley G., Gold A. Neurotic illness and its response to anxiolytic and antidepressant treatment. Psychol Med. 1980 May;10(2):321–328. doi: 10.1017/s0033291700044081. [DOI] [PubMed] [Google Scholar]
- Lader M. Dependence on benzodiazepines. J Clin Psychiatry. 1983 Apr;44(4):121–127. [PubMed] [Google Scholar]
- Rickels K., Case G. W., Winokur A., Swenson C. Long-term benzodiazepine therapy: benefits and risks. Psychopharmacol Bull. 1984 Fall;20(4):608–615. [PubMed] [Google Scholar]
- Rowland N., Irving J., Maynard A. Can general practitioners counsel? J R Coll Gen Pract. 1989 Mar;39(320):118–120. [PMC free article] [PubMed] [Google Scholar]
- Trethowan W. H. Pills for personal problems. Br Med J. 1975 Sep 27;3(5986):749–751. doi: 10.1136/bmj.3.5986.749. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tyrer P., Seivewright N., Murphy S., Ferguson B., Kingdon D., Barczak P., Brothwell J., Darling C., Gregory S., Johnson A. L. The Nottingham study of neurotic disorder: comparison of drug and psychological treatments. Lancet. 1988 Jul 30;2(8605):235–240. doi: 10.1016/s0140-6736(88)92535-4. [DOI] [PubMed] [Google Scholar]