Rate of Changing Diagnosis from Anxiety Disorders to Other Psychiatric Disorders and Associated Factors

Abstract

BACKGROUND: Although anxiety disorders are common, anxiety may be a symptom of other psychiatric disorders such as schizophrenia, depressive disorders, and obsessive-compulsive disorder. Patients initially diagnosed with anxiety disorders may ultimately have an alternative diagnosis.

OBJECTIVES: To investigate the rate of changing diagnosis from anxiety disorders to other psychiatric disorders, factors associated with changing diagnosis, and types of new diagnosis.

METHODS: The study design was a retrospective chart review. In total, 1,578 patients diagnosed with anxiety disorders and who visited the Psychiatric OPD at Siriraj Hospital between 1 January 2017 and 31 December 2020 were included in this study.

RESULTS: The overall rate of changing diagnosis from anxiety disorders to other psychiatric disorders is 12.7%. The rates of changing diagnosis after the 1-year, 3-year, and 5-year follow-up of anxiety disorders are 7.2%, 10.4%, and 12.1%, respectively. According to the results of a logistic regression model, the factors associated with changing diagnosis are being a man, taking benzodiazepine medication, having no other psychiatric comorbidity, having no diagnosis of panic disorder, and not being in remission status for disorders. In the changing diagnosis group, anxiety disorders are mostly replaced by depressive disorders, bipolar disorders, or psychotic disorders.

CONCLUSIONS: It is important to consider another diagnosis in patients who present with anxiety and receive a diagnosis of anxiety disorders to plan appropriate treatments.