Anxiety disorders in the general hospital setting

Area of Science:

• Medical research
• Psychiatry
• Health services research

Background:

• Anxiety disorders are prevalent in the general population but may be underdiagnosed in hospital settings.
• Understanding the characteristics and impact of anxiety comorbidity in medical/surgical inpatients is crucial for improving care.
• Previous studies suggest higher rates of anxiety symptoms in medical inpatients compared to diagnosed disorders.

Purpose of the Study:

• To determine the prevalence of anxiety disorders among adult medical/surgical inpatients.
• To identify demographic and clinical characteristics associated with anxiety comorbidity.
• To examine the impact of anxiety on hospital length of stay, mortality, and discharge disposition.

Main Methods:

• Analysis of the 1987 National Hospital Discharge Survey database.
• Inclusion of adult medical/surgical inpatients with a principal diagnosis.
• Comparison of inpatients with and without concurrent anxiety disorder diagnoses.

Main Results:

• One percent of adult medical/surgical inpatients had a concurrent anxiety disorder.
• Anxiety comorbidity was associated with older age, White race, female gender, and unmarried status.
• Inpatients with anxiety disorders had longer hospital stays and were less likely to die in the hospital.

Conclusions:

• Anxiety disorders are underdiagnosed in medical/surgical inpatients compared to community or screening estimates.
• Physicians may under-recognize anxiety or consider it an expected part of hospitalization.
• Psychiatric consultation for inpatients with anxiety may reduce hospital stays, cut costs, and improve care quality.