Abstract
INTRODUCTION: According to the official Russian source, in 2017 only 0.27% of the population of Russia was diagnosed with International Classification of Diseases, tenth revision (ICD-10) F4 category disorders (neurotic, stress-related and somatoform disorders), despite these disorders being among the most prevalent mental disorders worldwide. Here we report the results of a large-scale survey among Russian psychiatrists with the primary objective to assess the proportion of psychiatrists who use the diagnoses of interest (mixed anxiety and depression disorder [MADD], adjustment disorder [AdD], panic disorder [PD], agoraphobia, generalized anxiety disorder [GAD], social phobia, simple phobia, acute stress disorder and posttraumatic stress disorder) and compare results with those of a recent World Psychiatric Association (WPA) and World Health Organization (WHO) survey. We also compared the incidence of these diagnoses between state and non-state psychiatric services in Russia. METHODS: Mean proportions and distribution of proportions of participants who made diagnoses of interest at different rates were calculated and compared with the results of the recent WPA and WHO survey. Risk ratios (RR) of the incidence of these diagnoses made at a frequency of at least once a week were calculated to compare state and non-state psychiatric services. The 95% confidence intervals of the RRs were calculated using the Koopman asymptotic score method. RESULTS: Responses of 960 Russian psychiatrists were included in the analysis. Of these 95, 89 and 87% reported making diagnoses of MADD, AdD and PD, respectively, during the preceding 12 months, a far larger proportion compared to other disorders of interest. In general, a significantly smaller proportion of participants in our survey made diagnoses of anxiety disorders compared to respondents in the international WPA-WHO survey. Based on RRs, diagnoses of MADD, AdD, PD, GAD and acute stress disorder were less frequently made in the state-operated psychiatric service. CONCLUSION: Our survey revealed a serious underdiagnosis of anxiety disorders in Russia that may be associated with complex factors that include, but are not limited to the current stigma associated with the state-operated psychiatric service, which is still the exclusive source of official statistical data in Russia.