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In the patient who is anxious

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Anxiety: The primary care provider role

What to expect of a primary care clinician

  • Follow up on complaints of anxiety.
  • Clarify the major anxiety symptoms, use screening questions.
  • Discuss probable diagnosis.
  • Offer psychoeducation about self-help, psychotherapy, medication use.
  • Refer for community-based self-help if available.
  • If time and resources allow, provide:
    • bibliotherapy
    • self-help with assistance
    • brief exposure-based treatment
    • more intensive treatment if trained counsellors are available in the practice setting
  • Offer medication treatment:
    • second SSRI or SNRI +/- BZD
    • second SSRI or SNRI
    • specific augmentation
Adapted from: Richard Swinson, The patient who is anxious, Psychiatry in Primary Care (CAMH, 2011)

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Frequently asked questions

Clinical guidelines

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders (2014)

Generalised anxiety disorder and panic disorder in adults: management (NICE guideline CG113 2011) 

Social anxiety disorder: recognition, assessment and treatment (NICE guidelines CG159, 2013)