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Yaygın anksiyete bozukluğu: Birinci basamakta görülme sıklığı ve tanı güçlükleri

Generalized anxiety disorder: prevalence and diagnostic difficulties in primary care

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DOI: 
doi:10.2399/tahd.09.206

Keywords (Original Language):

Abstract (2. Language): 
Generalized anxiety disorder (GAD) presents with excessive worry¬ ing and marked hypervigilance symptoms. It has different diagnos¬ tic criteria in ICD (International Classification of Disease) and DSM (Diagnostic and Statistical Manual of Mental Disorders). Despite the differences in diagnosis, it is known to be the second most frequent mental disorder after depression in primary care. Besides the eco¬ nomic burden on the health care system, decreased quality of life with decreased productivity is striking in GAD. Physicians in various countries are known to have difficulties in diagnosing GAD. Although the complexity of this situation is frequently explained by the patients' presentations with physical symptoms rather than psy¬ chological and by the concern of stigmatization, is not possible to deny the contribution of the physicians' approach to mental illnesses. GAD patients applying primary care facilities for their treatment constitute an important part of the patients that physicians have difficulties in managing and experien frustration. In this brief review, we aim to raise awareness in primary care physicians about GAD and discuss the difficulties of its diagnosis in primary care.
Abstract (Original Language): 
Yaygın anksiyete bozukluğu (YAB) kendini aşırı endişe ve belirgin tetikte olma belirtileriyle gösterir. ICD (International Classification of Disease) ve DSM (Diagnostic and Statistical Manual of Mental Disorders) sınıflandırmalarında YAB için farklı tanı ölçütleri vardır: Tanı koymadaki bu farklılıklara rağmen YAB'nun birinci basamakta depresyondan sonra en sık görülen ruhsal bozukluk olduğu bilinmektedir. YAB, hastaların sağlık sistemine getirdikleri ekonomik yükün yanında, iş gücü kayıpları ve yaşam kalitesindeki düş¬ me oldukça çarpıcıdır. YAB tanısı koymada pek çok ülkede sorun yaşanmaktadır. Bu durum, hastanın sıklıkla psikolojik şikâyetlerden çok fiziksel semptomlarla başvurmasına ve damgalanma (stigmatizasyon) endişesine bağlansa da, hekimlerin ruhsal hastalıklara yaklaşımının payı da yadsınamaz. Tedavi için birinci basamağa başvuran YAB hastaları burada hekimin ilgilenmekte zorlandığı, hayal kırıklığı yaşadığı grup içinde de önemli yer tutmak¬ tadır. Bu kısa derlemenin amacı birinci basamak hekimlerinin dik¬ katini hastalığa ve birinci basamaktaki tanısının zorluklarına çek¬ mektir.
206-209

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