Treating Anxiety in Primary Care

Depressed patients treated in primary care settings benefit from structured, collaborative care that provides psychiatric consultation, combined psychotherapy and medication management, and frequent outreach. The best approach to primary care treatment of patients with anxiety disorders (panic disorder, generalized anxiety disorder, social anxiety disorder, and post-traumatic stress disorder) is less clear. In a randomized trial involving 17 primary care practices, 1004 adults (mean age, 43; 71% women) with anxiety disorders received structured case management or usual care.

Intervention patients received cognitive-behavioral therapy (CBT; provided by trained mental health personnel), anti-anxiety medication (provided by primary care clinici…