How do doctors treat anxiety

How family doctors are more effective at driving away anxiety disorder

BERLIN. General practitioners can help patients with anxiety and panic disorders better if they employ a short behavioral therapy program. This is the result of a study by the Institute for General Practice at Jena University Hospital.

According to this, 34 percent of the patients in the intervention group no longer had any symptoms twelve months after treatment. After standard treatment, this was the case in only 16 percent of those affected.

In addition, the patients in the intervention group had 182 anxiety-free days, 30 days more than those with standard treatment.

"For most of the ten million Germans with panic and anxiety disorders, the general practitioner is the only practitioner," says Professor Jochen Gensichen, director of the Jena Institute for General Practice and head of the Jena-PARADIES study (Patient Activation for Anxiety Disorders) .

419 patients with anxiety and panic disorders and 73 general practitioners took part. The Federal Ministry of Research funded the study, which began in 2012 and has now been completed.

It should clarify whether family doctors can treat their patients more effectively with new instruments and a stepped procedure than with standard therapy.

It takes almost 15 years for an anxiety disorder to be diagnosed

Professor Matthias Berger, neurologist at the University Clinic Freiburg, speaks of a "massive under-supply and incorrect supply of anxious patients in the outpatient sector".

According to studies by the TU Dresden, it would take an average of 14.7 years of life before an anxiety disorder is diagnosed and treated. General practitioners and internists are called upon to reach and care for the patients earlier. For around 70 percent of those affected, they are the first point of contact, according to Berger.

For the study, "Jamol" (Jena-Anxiety-Monitoring-List) was developed as the central work tool for the practice team. This includes, for example, a simple traffic light scheme to sort the patient's answers according to urgency during diagnostics.

The therapeutic procedure is also explained therein. The doctor first clarifies with the patient what triggers the fears and how these are expressed. Together with the patient, he then simulates the physical reactions - be it a racing heart, tremors or shortness of breath.

The patient learns - accompanied by the doctor - that the physical excitement soon drops again. Subsequently, with the help of a manual, he should perform the physical exercises alone and learn to control his fear through exposure.

Family doctors and MFA intensively involved

In addition to the family doctor, who advises and treats the patients on a total of four appointments, the medical assistant is also closely involved.

She takes over the monitoring of the patient and, in addition to a personal conversation at the beginning, maintains contact with him in ten further telephone calls. It records whether the patient is exercising, notes his experiences and in turn informs the doctor about the progress.

Brigitte Klein-GrĂ¼nert, family doctor in the Hof region, was involved in the study and is enthusiastic. "The procedure is very good and has a long-lasting effect," she says.

Many of the patients were also very grateful for the support. According to the director of studies, Gensichen, billing for the program is possible through basic psychosomatic care.