Clinical Summary: Empowering Community Psychiatry: A Cross-Sectional Study of the Prevalence of Generalized Anxiety Disorder in an Underserved Venezuelan Population
In an underserved Venezuelan primary care population without prior GAD diagnosis or current psychiatric pharmacotherapy, clinically meaningful anxiety symptoms were strikingly common. For psychiatrists and primary care clinicians working in resource-limited settings, the study highlights which readily identifiable factors track most strongly with greater anxiety severity and can guide who needs closer assessment.
Key Findings
- Based on HAM-A scores, 50.0% of the sample (n =220) was classified as having mild anxiety, 44.0% (n=194) moderate-to-severe anxiety, and 6.0% (n=26) mild-to-moderate anxiety.
- Psychosocial stress was reported by 67.9% (n=299) of participants and was strongly associated with anxiety severity (OR =124.6; 99% CI, 29.3–529.6; P<.001); among patients with stress, 64.0% (n =192) had moderate-to-severe anxiety.
- Among patients with moderate-to-severe anxiety, 85.7% (n=192) reported anxiety episodes and 90.0% (n=180) reported panic attacks; both were statistically associated with anxiety severity (OR =641.0; 99% CI, 138.5–2,966.8; P<.001 and OR=74.9; 99% CI, 30.2–185.7; P <.001, respectively).
- Alcohol use was reported by 77.8% of participants (n=316) and was significantly associated with anxiety severity (OR=3.4; 99% CI, 1.8–6.2; P<.001).
- A history of SARS-CoV-2 infection was reported by 47.27% of participants (n=208) and was significantly associated with anxiety severity (OR=1.9; 99% CI, 1.2–3.1; P < .001).
Anxiety burden was very high in this underserved Venezuelan primary care sample, with 94.0% showing at least mild symptoms on the HAM-A and 44.0% in the moderate-to-severe range. Screening and management should explicitly assess psychosocial stress, family history of anxiety and depression, alcohol use, unbalanced eating habits, prior anxiety or panic symptoms, and history of SARS-CoV-2 infection because these factors were significantly associated with higher anxiety severity.
Practice Implications
- Add routine anxiety assessment in community primary care settings serving underserved populations, because 50.0% of patients had mild anxiety and 44.0% had moderate-to-severe anxiety on the HAM-A.
- Pair anxiety screening with psychosocial stress assessment, since stress was present in 67.9% (n=299) of the sample and showed the strongest association with anxiety severity (OR =124.6; 99% CI, 29.3–529.6; P<.001).
- When patients report lifetime anxiety episodes or panic attacks, move quickly to diagnostic clarification and symptom-severity assessment, given their high co-occurrence with moderate-to-severe anxiety: 85.7% (n=192) and 90.0% (n=180), respectively.
- Include alcohol use, family history of anxiety or depression, unbalanced eating habits, and history of SARS-CoV-2 infection in the clinical interview, because these variables were significantly associated with higher anxiety severity in this sample.
