CONCEPT PAPERS

A requirement in Seminars in Abnormal Psychology

By Denise C. Dino

Masters in Psychology Clinical Psychology

January 30, 2016

Dr. Nenita Buan

Professor, MP Chairperson
Title of Proposed Study

Get Help on Anxiety Disorders: A Eye-opener survey for Filipinos

Area of Study

The area in psychology that this study would want to undertake is anxiety disorder
focusing on Filipinos sensitivity to anxiety disorders.

Background to the Study

A study from the Department of Psychiatry and Behavioral Medicine, College of

Medicine and Philippine General Hospital, University of the Philippines, Manila, entitled
A Validation of the Hospital Anxiety and Depression Scale (HADS), which the
researcher used HADS as a tool that can determine depression and anxiety. Filipino
patients have stigma when it comes to psychiatric referrals. Because of this, the
researcher experienced difficulty in gathering data and it is done inside the PGH.
Patients with psychiatric morbidity can significantly influence the course of medical
illness, lengthen the duration of hospital stay, and lead to patients poor compliance to
medication and treatment follow-ups. Some people experience it but they just dont
know that it is a kind of anxiety disorder because they are not aware about it. That is the
concern of this study.

Statement of the Problem

Here in the Philippines, only few studies were conducted about anxiety disorders. This
study aim to enlighten Filipinos about anxiety disorders.

Objectives of the Study

The main objective of this study is to give awareness to Filipino people about the
anxiety disorders and get to know the agencies that will help a person suffering to this
kind of illness.

Questions and/or Hypotheses

1. What is the profile of the Filipino respondents in terms of:

a. Gender
b. Age
c. Marital status
d. Educational background
e. Economic background
f. Location
 2. What are the common perceptions or ideas that a Filipino has about psychiatric
illness? Do they know about anxiety disorder? How do they know about it?
3. What are the common signs of anxiety that the respondents have identified after
taking the Likert scale ADM (Anxiety Disorder Measurement) and how severe is
their experiences?
4. How they have reacted with the statements in the survey?
5. What are the agencies in the Philippines which provides basic knowledge about
psychiatric illness? How much attention that the Philippine government agency
and private agencies give to people who suffers from psychiatric illness?

Literature Review

Anxiety disorders include disorders that share features of excessive fear and
anxiety and related behavioral disturbance. (DSM-5) According to Cambridge
Dictionary, anxiety disorder is any one of several mental disorders in which anxiety is
the central feature, including panic disorder and agoraphobia, generalized anxiety
disorder, phobias, obsessive-compulsive disorder, post-traumatic stress disorder, and
anxiety disorders due to medical condition or drug abuse.

There are researchers in any Asian countries like Philippines are recently having
an interest in conducting a study about anxiety, yet there are some problems that has
been experiencing since then. According to Tan SK, et al, it has been noted that anxiety
disorder in the Philippines has not been explored. A study of De Guzman, Ma. Lourdes
Rosanna of PGH, depression and anxiety are the most common mental disorders
among medically ill patients admitted in the general hospital with a reported prevalence
of 10% - 50 %.1 Being the final common pathway resulting from the interaction of
biological, psychological and social factors, ways of improving the identification of
psychiatric morbidity need to be found, because this can significantly impair the course
of treatment and management of the medical illness in patients admitted to the general
hospital. The under-recognition of psychiatric disorders is handicapped by the
biomedical view of medical illness, which focuses more on physical signs and
symptoms to the exclusion of psychological problems. This makes it difficult for the
clinician to recognize promptly, to assess and to manage adequately any psychological
distress among the medically-ill. This difficulty is reinforced by the patients
unwillingness to disclose any emotional problems and by the medical staffs reluctance
to inquire about psychological problems because of the stigma of mental illness. 2 In the
study population, the prevalence of clinical depression is 26.9%; followed by anxiety
disorder with a prevalence of 14.3%, and prevalence of a mixed diagnosis of
depression and anxiety was 13.7% based on psychiatric evaluation. These estimates
represent the proportion of medically-ill patients having depression and anxiety. The
conditions that featured prominent depression, anxiety, or both as a cardinal
characteristic were pooled into one category of depression and anxiety, which showed
an overall prevalence rate of 54.9%. According to medical diagnosis, the prevalence of
depression and anxiety was higher among those with a medical diagnosis (60.8%)
compared to those with a surgical diagnosis (51.4%), which was significant ( with 2 df
= 5.438; p-value < 0.020). Duration of hospital stay is defined as the number of days of
hospitalization from the time of admission up to the time of psychiatric evaluation. As to
duration of hospital stay, the prevalence was highest among those who stayed longest >
14 days (69.1%) than those who stayed for 7 days or less (54.7%). On the other hand,
those who stayed between 814 days (39.9%) had the lowest figure. The variation in
prevalence was significant ( with 2 df = 29.965; p-value = 0.000). As to history of
mental illness, the prevalence of depression and anxiety was higher among those with a
(+) history of mental illness (61.4%) than those with negative history of mental illness
(54.2%). However, the difference was not statistically significant ( with 2 df =1.078; p-
value = 0.299).

International studies by Mayou and Hawton3 reported the prevalence of

depression and anxiety in the medically ill from 15% to 59%. The local study by Perlas
and Querijero determined the prevalence of psychiatric disorders among the chronic
medically-ill patients in selected tertiary hospitals with depression having the highest
prevalence at 32.1% and anxiety at 16.3%.4

In this study, among the medically-ill in-patients, the prevalence of depression is

26.9% and anxiety is 14.3%. The prevalence of depression and anxiety was highest
among those with a medical diagnosis compared to those with a surgical diagnosis and
among those with a longer duration of hospital stay >14 days (number of days from the
time of admission up to the time of psychiatric evaluation). As to demographic factors,
the prevalence of depression and anxiety was highest among the younger adult age
group of 18 35 years; among males; among those who are married/live-in; and,
among those with a lower educational attainment.

Based on the study conducted by Tanja, Michael et al., there are risks factors for
anxiety disorders. Their study focuses on epidemiological research on the subject
matter where their attention was on the examining influence of genetic factors
behavioral inhibition negative life events and upbringing on the subsequent onset of
anxiety. Though there are some problems about the specificity of anxiety disorder,
somehow other Asian researchers try to resolve this issue by checking how the Asian
population presents anxiety disorder by considering culture distress syndrome. By
looking at how people perceive they claimed to be symptoms of anxiety or the
equivalent of this in their country they will be able to know how it will be treated.

Through this study, the knowledge of Filipinos about anxiety disorder will be explored
outside institutions and hospitals and results from some researches will be applied and
compared with the results to be taken from this study.
Proposed Research Design, Methods/Procedures

Descriptive method of research shall be used in this study. Descriptive research

describes what is. It involves the description, recording, analysis, and interpretation of
the present nature, composition or process of phenomena. It focuses on prevailing
conditions, or how a person, group or thing behaves or functions in the present. It often
involves some type of comparison or contrast (Yin as cited by Amante, et.al.2008). The
researcher will gather pool of respondents in different barangays in Manila City, Metro
Manila with the intention to know how Filipinos perceive anxiety disorders.

In doing this, permission letter will be given to the office of the mayor of Manila signed
by the Chairperson of Master in Psychology and President of Polytechnic University of
the Philippines.

After the approval, the researcher will administer the survey in the barangay hall and will
also conduct interviews to each respondent after the answering the survey.

The number of respondents to be taken from the population is 500. The ages of the
respondents will range from 18 60 from male and female population also considering
their gender. The prospected respondent must be at least attained grade 2 in
elementary. No other requirement must be met.

Bibliography
Creed F. Assessing depression in the context of physical illness. In: Robertson MM, Katona CLE, eds.
Perspectives in Psychiatry: Depression and Physical Illness. Volume 3. Crichester: John Wiley &
Sons; 1997. pp. 3-7.

Maguire P, Hopwood P, Tarrier N, Howell T. Treatment of depression in cancer patients. Acta Psychiatr
Scand Suppl. 1985; 320:814.

Mayou R, Hawton K. Psychiatric disorder in the general hospital. Br J Psychiatry. 1986; 149:172-90.

Perlas AO, Querijero MB, Abcede DA, et al. The prevalence of psychiatric disorders among the
chronically-ill medical patients in selected tertiary hospitals in the Philippines. Philipp J Psych. 2004;
28(1):7-24.

DSM -5

Cambridge Dictionary

De Guzman, Ma. Lourdes Rossana. A Validation of the Hospital Anxiety and Depression Scale (HADS) in
the Medically-Ill

Tan, et al.: Prevalence of Anxiety and Depression Among Filipino Patients with Chronic Obstructive
Pulmonary Disease: A Multi-Center Study