[Management of complex anxiety disorders-A case for inpatient treatment?]

Background: Anxiety disorders are among the most frequent psychiatric disorders. Although the vast majority of patients in Germany are treated on an outpatient basis, anxiety disorders also play an important role in day care and inpatient care. Among other aspects, this is against the background of comorbidities, treatment-resistant courses or complications such as suicidal ideation.

Material and methods: As part of an evaluation of the basic psychiatric documentation (BADO) data from 894 patients with anxiety disorders treated in a day care or inpatient setting in a German psychiatric community hospital were evaluated over a period of 7 years.

Results: It was found that 89% of the patients had already been treated before admission and that 70% had been under medication prior to admission: patients with panic disorder made up the largest group of patients with 48%. On the date of admission 48% of patients had been treated with a selective serotonin reuptake inhibitor (SSRI) and 37% had received a benzodiazepine. Furthermore, 75% of the patients had psychiatric comorbidities. Somatic illnesses played an important role in 40% of the patients.

Discussion: The present results underline that a significant proportion of patients with anxiety disorders also require inpatient or day care treatment. Most patients had been previously treated and had not responded to therapy in an outpatient setting. Possible consequences with respect to the optimization of outpatient treatment options and the need to maintain day care and inpatient resources for this patient group, are discussed.