Diagnosis and treatment of Anxiety Disorders in Russia: The Results of a Web-based Survey of Psychiatrists

Abstract

Introduction. There is a lack of data of the prevalence of anxiety disorders in Russia; the official statistic shows a rare usage of diagnoses of whole chapter F4 “Neurotic, stressFrelated
and somatoform disorders”.
Objective and methods. In order to evaluate the practical experience of diagnosis and treatment of anxiety disorders by Russian psychiatrists, as well as assessing the relative frequency of
these diagnoses utilization, an online survey was conducted by Russian Society of Psychiatrists. 1015 psychiatrists from 75 regions of Russia took part in the survey. Respondents’ answers
regarding the frequency of the use of the diagnostic categories were compared with data from the WPAFWHO survey.
Results. Percentage of participating psychiatrists indicating that they use diagnosis of anxiety disorders at least once a week in their dayFtoFday clinical practice was 11,9 % in the RSP
survey and 33,6 % in the WPAFWHO survey. Most often diagnoses of these disorders are used by psychotherapists and respondents working in the somatic network and private practice.
Among anxious and stressFrelated disorders, most often Russian psychiatrists use the diagnoses of “mixed anxiety and depressive disorder” and “adjustment disorders”, which in their essence
are preliminary diagnoses and often do not lead to the appointment of an adequate therapy. The diagnosis of generalized anxiety disorder in Russia is used much less often than in the world,
whereas panic disorder, on the contrary, is more frequent. Most respondents (84 %) do not diagnose anxiety disorders as second diagnoses in people who suffer from other mental disorders.
The treatment of anxiety disorders by Russian psychiatrists is largely in line with international clinical guidelines, but doctors also widely prescribe drugs with unproven efficacy, and do not
follow the therapeutic algorithms in the sequence of prescribing drugs and the duration of therapy.
Conclusions. Diagnoses of anxiety disorders are used by Russian psychiatrists much less often than by psychiatrists from other countries. Increasing attention to anxiety disorders in the
psychiatrists’ education programs may improve its diagnosis and treatment.