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Lifestyle key to anxiety

By Gareth Iacobucci

Persuading patients to modify their lifestyle is more effective than standard GP care at tackling anxiety, a new primary care study concludes.

GP referral for a lifestyle review – focusing on areas such as consumption of caffeine and alcohol – had substantial medium-term benefits for easing panic attacks.

The researchers insisted guidelines on panic disorder should change to promote the benefits of modifying lifestyle, and said GPs could routinely discuss lifestyle causes in consultations (see below).

The study at 15 practices in the East of England found that after 20 weeks, 64 per cent of patients in the lifestyle arm were panic-free, compared with 40 per cent under usual care.

After 10 months, the number of patients who were panic-free was 68 per cent in the lifestyle arm and 49 per cent for usual care, although the difference had ceased to be significant.

Study leader Rod Lambert, an occupational therapist at the school of allied health professions, University Of East Anglia, said: 'I certainly think lifestyle should be considered in clinical guidelines. If we can get it on the treatment agenda of primary care in a more definite way, then we stand a chance of helping people regain control over their own symptoms.'

The study, published in the Journal of Affective Disorders last month, randomised 199 patients with panic disorder to lifestyle advice or usual care, although fewer than half of patients in each arm completed the 10-month study.

The lifestyle arm consisted of referral to an occupational therapist for up to 10 intervention sessions over a 16-week period, to discuss diet, fluid intake, exercise and consumption of caffeine, alcohol and nicotine.

Mr Lambert added: 'We are aiming to look at a broader range of anxiety conditions to take the research forward.'

Dr Chris Manning, chief executive of Primary Care Mental Health and Education, said GPs could take greater advantage of non-medical professionals to help manage mental health disorders. 'We have got to start moving people out of the medical sphere and looking at more communal and societal solutions to people's predicaments.

'I'm very sympathetic to peer-to-peer counselling, although I am concerned about the qualifications of the people who are offering it.'

Triggers for lifestyle advice

Aspects of daily lifestyle which may provoke concern

•Drinking more than two mugs of coffee

•More than three mugs of tea

•More than two alcoholic drinks

•Drinking less than 1.5 litres of fluid

•Smoking more than five cigarettes

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