Barriers to diagnosing anxiety disorders in family practice

Although anxiety disorders are common, their accurate diagnosis and effective treatment may be hindered by both physician and patient factors. Both denial on the part of patients and avoidance of conflict by physicians may be based on outdated concepts of stigma attached to "mental" illness and failure to accept the biopsychosocial model of illness. Physician failure to discriminate between the different anxiety conditions and to recommend the treatment appropriate for each specific diagnosis are additional significant barriers. The situation is further complicated when the patient's symptoms change over time. Although both physician and patient may experience significant discomfort in exploring anxiety symptoms, a thorough clinical history is essential to the diagnosis and provides the basis for successful management of these conditions.