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Diagnosis and treatment of Anxiety Disorders in Russia: The Results of a Web-based Survey of Psychiatrists

N.G. Neznanov 1, I.A. Martynikhin 2, S.N. Mosolov 3
1 St. Petersburg V.M. Bekhterev Psychoneurological Research Institute, St. Petersburg, Russia
2 Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
3 Moscow Research Institute of Psychiatry, Moscow, Russia

Introduction. There is a lack of data of the prevalence of anxiety disorders in Russia; the official statistic shows a rare usage of diagnoses of whole chapter F4 “Neurotic, stress-related and somatoform disorders”.

Objective and methods.In order to evaluate the practical experience of diagnosis and treatment of anxiety disorders by Russian psychiatrists, as well as assessing the relative frequency of these diagnoses utilization, an online survey was conducted by Russian Society of Psychiatrists. 1015 psychiatrists from 75 regions of Russia took part in the survey. Respondents' answers regarding the frequency of the use of the diagnostic categories were compared with data from the WPA-WHO survey.

Results.Percentage of participating psychiatrists indicating that they use diagnosis of anxiety disorders at least once a week in their day-to-day clinical practice was 11,9 % in the RSP survey and 33,6 % in the WPA-WHO survey. Most often diagnoses of these disorders are used by psychotherapists and respondents working in the somatic network and private practice. Among anxious and stress-related disorders, most often Russian psychiatrists use the diagnoses of “mixed anxiety and depressive disorder” and “adjustment disorders”, which in their essence are preliminary diagnoses and often do not lead to the appointment of an adequate therapy. The diagnosis of generalized anxiety disorder in Russia is used much less often than in the world, whereas panic disorder, on the contrary, is more frequent. Most respondents (84 %) do not diagnose anxiety disorders as second diagnoses in people who suffer from other mental disorders. The treatment of anxiety disorders by Russian psychiatrists is largely in line with international clinical guidelines, but doctors also widely prescribe drugs with unproven efficacy, and do not follow the therapeutic algorithms in the sequence of prescribing drugs and the duration of therapy.

Conclusions.Diagnoses of anxiety disorders are used by Russian psychiatrists much less often than by psychiatrists from other countries. Increasing attention to anxiety disorders in the psychiatrists’ education programs may improve its diagnosis and treatment.

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