http://www.gopubmed.org/web/gopubmed/1?WEB0lqehl43c1aruI47I8bI0 anxiety and mental health care and primary care 1,169 documents semantically analyzed top author Katon, W Seattle, USA Senior author (75 last author) URL to this profile Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195. statistics 1 2 Top Years Publications 2009 125 2006 106 2008 102 2007 85 2005 84 2004 69 2003 64 2001 59 2010 49 1999 48 2002 45 2000 43 1997 41 1998 37 1996 37 1995 27 1993 22 1994 17 1992 17 1991 14 1 2 1 2 3 4 Top Countries Publications USA 478 United Kingdom 157 Netherlands 64 Australia 50 Spain 49 Canada 48 Germany 34 France 17 Colombia 16 Italy 16 Sweden 16 Norway 13 Israel 13 Brazil 11 Denmark 9 Finland 9 New Zealand 8 Nigeria 8 Hungary 6 India 6 1 2 3 4 1 2 3 ... 18 Top Cities Publications New York 45 London 44 Seattle 35 Boston 34 Manchester 25 Amsterdam 21 Bethesda 20 Philadelphia 19 Los Angeles 18 Washington 17 Utrecht 16 Sydney 15 Barcelona 14 San Diego 14 Toronto 13 Paris 12 Montreal 11 Madrid 11 Rochester 10 San Francisco 10 1 2 3 ... 18 1 2 3 ... 22 Top Journals Publications Gen Hosp Psychiat 34 Psychol Med 33 Aten Primaria 27 Soc Psychiatry Psychiatr Epidemiol 26 Am J Psychiat 24 Int J Psychiat Med 21 J Clin Psychiat 21 Depress Anxiety 20 Arch Gen Psychiat 18 J Gen Intern Med 17 Med Care 16 Psychiat Serv 16 Int J Geriatr Psychiatry 15 Brit J Gen Pract 15 J Affect Disorders 14 Psychosom Med 14 J Psychosom Res 13 Brit J Psychiat 13 J Fam Practice 12 J Clin Psychiatry 11 1 2 3 ... 22 1 2 3 ... 99 Top Terms Publications Humans 1,094 Anxiety 1,040 Primary Health Care 902 Patients 772 Depression 728 Adult 684 Mental Health 606 Mental Disorders 595 Anxiety Disorders 585 Middle Aged 550 Diagnosis 425 Questionnaires 388 Aged 388 Prevalence 377 Adolescent 347 Depressive Disorder 337 Health Care 297 Physicians, Family 294 Evaluation Studies as Topic 289 Comorbidity 281 1 2 3 ... 99 1 2 3 ... 205 Top Authors Publications Katon W 25 Olfson M 21 Stein M 20 Roy-Byrne P 20 Sherbourne C 19 Weissman M 18 Kroenke K 14 Russo J 14 Craske M 13 Spitzer R 13 Leon A 11 Keller M 10 Simon G 10 Wells K 10 Broadhead W 10 Bystritsky A 9 Wittchen H 9 Kessler R 8 Lecrubier Y 7 Levkoff S 7 1 2 3 ... 205 最新医学证据 Roy-Byrne P, Craske MG, Sullivan G, et al. Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA. 2010 May 19;303(19):1921-8. (Original) PMID: 20483968 ReadAbstract ReadComments Clinical Evidence Topics: Generalisedanxietydisorder Post-traumaticstressdisorder Panicdisorder Depressioninadults:psychologicaltreatmentsandcarepathways DISCIPLINE RELEVANCE TO PRACTICE IS THIS NEWS? General Internal Medicine-Primary Care(US) General Practice(GP)/Family Practice(FP) GP/FP/Mental Health * * Psychiatry * * * Ratings pending login to http://plus.mcmaster.ca/evidenceupdates in a few days if interested. Print Save Article Delete Article Email this article to a colleague Abstract CONTEXT: Improving the quality of mental health care requires moving clinical interventions from controlled research settings into real-world practice settings. Although such advances have been made for depression, little work has been performed for anxiety disorders. OBJECTIVE: To determine whether a flexible treatment-delivery model for multiple primary care anxiety disorders (panic, generalized anxiety, social anxiety, and posttraumatic stress disorders) would be better than usual care (UC). Design, Setting, and PATIENTS: A randomized controlled effectiveness trial of Coordinated Anxiety Learning and Management (CALM) compared with UC in 17 primary care clinics in 4 US cities. Between June 2006 and April 2008, 1004 patients with anxiety disorders (with or without major depression), aged 18 to 75 years, English- or Spanish-speaking, were enrolled and subsequently received treatment for 3 to 12 months. Blinded follow-up assessments at 6, 12, and 18 months after baseline were completed in October 2009. INTERVENTION: CALM allowed choice of cognitive behavioral therapy (CBT), medication, or both; included real-time Web-based outcomes monitoring to optimize treatment decisions; and a computer-assisted program to optimize delivery of CBT by nonexpert care managers who also assisted primary care clinicians in promoting adherence and optimizing medications. MAIN OUTCOME MEASURES: Twelve-item Brief Symptom Inventory (BSI-12) anxiety and somatic symptoms score. Secondary outcomes included proportion of responders (/=50% reduction from pretreatment BSI-12 score) and remitters (total BSI-12 score 6). RESULTS: A significantly greater improvement for CALM vs UC in global anxiety symptoms was found (BSI-12 group mean differences of -2.49 , -2.63 , and -1.63 at 6, 12, and 18 months, respectively). At 12 months, response and remission rates (CALM vs UC) were 63.66% (95% CI, 58.95%-68.37%) vs 44.68% (95% CI, 39.76%-49.59%), and 51.49% (95% CI, 46.60%-56.38%) vs 33.28% (95% CI, 28.62%-37.93%), with a number needed to treat of 5.27 (95% CI, 4.18-7.13) for response and 5.50 (95% CI, 4.32-7.55) for remission. CONCLUSION: For patients with anxiety disorders treated in primary care clinics, CALM compared with UC resulted in greater improvement in anxiety symptoms, depression symptoms, functional disability, and quality of care during 18 months of follow-up. Trial Registration clinicaltrials.gov Identifier: NCT00347269. Comments from Clinical Raters General Internal Medicine-Primary Care(US) Seems like a very effective intervention but it takes a significant investment of time and resources on the part of the primary care provider. Psychiatry More studies like this one are needed. It appeared in a recent issue of JAMA devoted to mental health, which was in general of great interest for Primary Care doctors and psychiatrists.
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