Primary prevention of anxiety disorders in primary care: A systematic review

Objective. Anxiety disorders are the most prevalent psychiatric disorders in primary care and have significant social, economic, and interpersonal costs. Primary care is an ideal setting to prevent the appearance of anxiety disorders. The aim of this study was to evaluate the efficacy and cost-effectiveness of primary prevention interventions in anxiety disorders in the adult population receiving primary health care. Methods. A literature search was carried out in four databases-PubMed, Psyclnfo, Cochrane, and Web of Science from January 1980 to November 2013. Clinical trials and systematic reviews published in English and non-English languages and that evaluated the efficacy and/or cost-effectiveness of interventions of primary prevention for anxiety in primary care in the general adult population were included. Risk of bias was assessed by the Cochrane Risk Bias Tool and Overview Quality Assessment Questionnaire. Results. No high-quality research was identified that studied primary prevention of anxiety disorders in the adult population in the primary care setting. The few studies that exist focus on the child-adolescent population or on other types of interventions, usually as secondary prevention. Conclusion. This study emphasizes the need for the development of high-quality clinical trials on the prevention of anxiety disorders in primary care. (C) 2014 Elsevier Inc. All rights reserved.