GPs should use a two-part questionnaire to ask patients about their feelings of anxiety in order to identify those who require treatment, says draft guidance from NICE.
The draft guideline says GPs should use the two-item Generalized Anxiety Disorder scale (GAD-2) in patients showing symptoms of social anxiety and those who have recently experienced a traumatic event.
Published this month, the guidance recommends cognitive behavioural therapy as the first-line treatment. It also says patients who decline CBT should be offered supported self-help or an antidepressant – fluvoxamine1 or escitalopram – after the reasons for declining CBT have been discussed.
GPs should also consider offering patients with anxiety disorders home visits, or appointments outside of normal hours, the draft guidance recommends.
The guidance says: ‘Be alert to possible anxiety disorders (particularly in people with a past history of an anxiety disorder, possible somatic symptoms of an anxiety disorder or in those who have experienced a recent traumatic event).
‘Consider asking the person about their feelings of anxiety and their ability to stop or control worry, using the two-item Generalized Anxiety Disorder scale.’
Professor Mark Baker, director of the Centre for Clinical Practice at NICE, said: ‘We hope that the development of NICE guidance in this area will help ensure that those affected by this disorder receive the best possible support.’