National Post

Monday, February 22, 1999

Psychologist claims most anxiety patients are receiving the wrong treatment

Carol Milstone, PhD
National Post

Worrywarts. The worried well. Psychologists prefer the term anxiety, defining it as thoughts or expectations of danger or misfortune, accompanied by tension and feelings of sickness. Common concerns are about serious illness, accidents, or personal failure. Mild anxiety is a regular visitor to human existence, but when nagging concerns start dogging a person's day-to-day existence, he or she might have an anxiety disorder. In their fullest glory, anxiety disorders can bring on panic attacks, phobias, obsessive-compulsive disorder, and psychosomatic illness. In the current Canadian Psychology journal, Canadian Psychological Association past-president Janel Gauthier of Universite Laval presents some unnerving findings on the treatment of anxiety disorders, which claim 25% of people (mostly women) at some point in their lives. According to Gauthier, an estimated 90% of anxiety patients in Canada are receiving inappropriate treatment. They might be prescribed the wrong drugs, or receive forms of psychotherapy which could make matters worse. "Professionals outside of anxiety disorder clinics or research centres have a poor knowledge of the empirically validated interventions for anxiety disorders," says Gauthier. Another problem is a debate over medication or psychological intervention. While people with anxiety disorders are clearly biologically different from non-anxious people in brain imaging, chemistry, and genetics, it is not clear whether their behavioural responses to stress are contributing to these differences. According to Gauthier, "investigators from biological and behavioural perspectives rarely collaborate . . . and rarely read one another's work, except to criticize it." For example, psychologists have developed programs for panic disorder which are less costly, followed through more often, and have longer-term benefits than medication. These largely work on cognitive restructuring -- teaching patients to replace fearful thoughts with more rational, less scary ones. Yet medical doctors still tend to prescribe drugs for panic disorder. On the other hand, some anxiety disorders, like obsessive-compulsive disorder, are now better treated with medication, yet many psychologists still persist with psychological prodding (although certain behavioural approaches are showing promise for this disorder as well).

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