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Articles   |    
Service Utilization Among Veterans With Schizophrenia and a Comorbid Anxiety Disorder
Denis G. Birgenheir, Ph.D.; Dara Ganoczy, M.P.H.; Nicholas W. Bowersox, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300316
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At the time of the study, all authors were with Health Services Research and Development, U.S. Department of Veterans Affairs (VA) Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan (e-mail: denis.birgenheir@va.gov). Dr. Birgenheir is now with the Mental Health Department, VA Nebraska–Western Iowa Healthcare System, Omaha, Nebraska.

Copyright © 2014 by the American Psychiatric Association

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Abstract

Objective  The objective was to assess the prevalence and impact of anxiety disorders on service utilization among Veterans Health Administration (VHA) patients with schizophrenia.

Methods  This cross-sectional study examined diagnostic, utilization, and medication records included in the VHA National Psychosis Registry. Relationships between schizophrenia and anxiety disorders were evaluated along demographic and service utilization dimensions.

Results  During fiscal year 2011, 23.8% (N=20,722) of 87,006 VHA patients with schizophrenia were diagnosed as having a comorbid anxiety disorder; 15.2% of the sample had a posttraumatic stress disorder (PTSD) diagnosis and 8.6% a non-PTSD anxiety disorder. Comorbid anxiety disorders were associated with increased psychiatric comorbidity (depression, personality disorder, and substance use disorder), higher rates of psychiatric and medical hospitalization, and increased utilization of outpatient mental health services.

Conclusions  Anxiety disorders are common among individuals with schizophrenia within the VHA and appeared in this study to convey additional disability in terms of psychiatric comorbidity and the need for increased psychiatric care. Future research should investigate ways to improve detection and enhance treatment provided to this population.

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