Diagnostic specificity and mental health service utilization among veterans with newly diagnosed anxiety disorders

Gen Hosp Psychiatry. Mar-Apr 2014;36(2):192-8. doi: 10.1016/j.genhosppsych.2013.10.013. Epub 2013 Oct 22.


Objective: This study examined rates of specific anxiety diagnoses (posttraumatic stress disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia) and anxiety disorder not otherwise specified (anxiety NOS) in a national sample of Veterans and assessed their mental health service utilization.

Method: This study used administrative data extracted from Veteran Health Administration outpatient records to identify patients with a new anxiety diagnosis in fiscal year 2010 (N = 292,244). Logistic regression analyses examined associations among diagnostic specificity, diagnostic location, and mental health service utilization.

Results: Anxiety NOS was diagnosed in 38% of the sample. Patients in specialty mental health were less likely to receive an anxiety NOS diagnosis than patients in primary care (odds ratio [OR] = 0.36). Patients with a specific anxiety diagnosis were more likely to receive mental health services than those with anxiety NOS (OR = 1.65), as were patients diagnosed in specialty mental health compared with those diagnosed in primary care (OR = 16.29).

Conclusion: Veterans diagnosed with anxiety NOS are less likely to access mental health services than those with a specific anxiety diagnosis, suggesting the need for enhanced diagnostic and referral practices, particularly in primary care settings.

Keywords: Anxiety; Anxiety disorder not otherwise specified; Diagnostic; Mental health service utilization; Veteran.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Obsessive-Compulsive Disorder / epidemiology
  • Obsessive-Compulsive Disorder / psychology
  • Odds Ratio
  • Outpatients
  • Panic Disorder / epidemiology
  • Panic Disorder / psychology
  • Phobic Disorders / epidemiology
  • Phobic Disorders / psychology
  • Primary Health Care / statistics & numerical data*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology
  • United States / epidemiology
  • United States Department of Veterans Affairs
  • Veterans / psychology
  • Veterans / statistics & numerical data*