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NEW YORK (Reuters Health) Oct 24 - A study in the September issue of the Journal of the American Geriatrics Society suggests that primary care physicians are less likely to identify anxiety in older black Americans than in white patients.

"The primary healthcare setting is pivotal for the identification and treatment of mental disorders, because elderly patients remain underserved by mental health providers," write Dr. Hillary R. Bogner and colleagues from the University of Pennsylvania in Philadelphia.

Their study involved 330 elderly patients from Maryland primary care practices who had consented to in-home interviews consisting of a 90-minute survey regarding their psychological status and use of psychotropic medicines. The physicians were later asked to rate their patients' anxiety on a 4-point scale.

Older black patients were less likely than older white patients to be identified by their physicians as anxious (odds ratio = 0.34). The association between ethnicity and identification of anxiety remained unchanged in multivariate models controlling for influential characteristics, including severity of anxiety, functional status, and medical conditions. Overall, 24.5% of anxious black patients were receiving psychotropic medication, compared with 44.6% of anxious white patients (adjusted odds ratio = 0.40, p < 0.01).

"The current study emphasizes that physicians caring for black patients should be cognizant of the tendency for anxiety symptoms to be judged as not severe," Dr. Bogner and colleagues warn. "To facilitate the doctor-patient interaction, physicians might introduce this fact into their interviews when appropriate and determine whether this leads to a different conversation with their black patients."

 

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