Anxiety Tool Kit

HKC Bottom Line

• Anxiety disorders are common and treatment can substantially improve quality of life. Separating "normal" anxiety from a disorder can be challenging and it may be helpful to inform patients early that anxiety causes many physical symptoms (e.g. 1/3 of palpitations are related to anxiety) while ruling out other possible diagnoses.

HKC Recommended Article

• Best Evidence. Clinical Review: Treating Generalized Anxiety Disorder (Mar 2003). Brief but provides summary of evidence on the efficacy of different classes.

Disease Overview

  General

• New Zealand Guideline. Assessing and Treating Anxiety Disorders (1998).

   Tools

• Pfizer. The Patient Health Questionnaire (1999). Developed by Spitzer for Pfizer, it can be filled in by clinician or patient and has shown excellent reliability in screening for mental health conditions. Includes depression, anxiety, violence, etc.

Management and Prescribing Advice

  General

• RX Files. Benzodiazepines Comparison Chart (Sept 2005). Complete with drug-specific information (dose, onset, half-life, comments and cost).
  
  
• BMJ. ABC of Psychological Medicine: Anxiety in Medical Patients (2002). Brief but comprehensive including information on diagnosis and management.

  Drug Specific

• BMJ Clinical Review. Treating Generalized Anxiety Disorder (2003). Brief, but provides general summary of "what works" and "what doesn't work".
  
  
• RX Files. Anxiety Disorder Medication Comparison Chart (Sept 2005). Complete with drug-specific information (dose, onset, half-life, comments and cost).

  Other Modalities

• ICES Informed. CBT Therapy (Apr 2003). Overview of the application and quality of evidence for CBT in mental conditions, including anxiety.

Algorithms

• Ontario Guidelines for the Management of Anxiety Disorders in Primary Care- Algorithm (2000).
  
  
• Using DSM-IV Primary Care Version: A Guide to Psychiatric Diagnosis in Primary Care with Algorithm outlining the DSM-IVPC approach to the diagnosis of anxiety disorders (1998).

Patient Resources

  Printable Patient Handouts

• Healthy Ontario. Anxiety.
  Printable, Canadian resource.
  
  
• College of Family Physicians of Canada. Anxiety and Panic: Gaining Control Over How You're Feeling.
  Printable, Canadian and a good overview of disease and non-pharmaceutical measures. Doesn't include information on drugs.
  
  
• National Institute of Mental Health. Anxiety Disorders.
  Very extensive patient information with a printable version (although 36 pages).

  Web-Based Resources

• The Panic Center.
  Informative website for the patient and they can fill in the questionnaire and bring in the results to you.
  
  
• Canadian Network for Mood and Anxiety Treatments.
  Good resource for patient who is seeking comprehensive information.
  
  
• Anxiety Disorders Association of Ontario.
  Good for people looking for a support network on the web.
  
  
• Anxiety Disorder Association of America.
  Good as a resource for patients, includes access to information on support groups, etc.

  Tools

• The Panic Center. Informative website for the patient and they can fill in the questionnaire and bring in the results to you.