Choose one Diagnosis from the anxiety disorders group
Choose one Diagnosis from the anxiety disorders group
Anxiety disorders are the most common type of mental illness in Europe, with a 12-month prevalence of 14% among persons aged 14 to 65. Their onset is usually in adolescence or early adulthood. The affected patients often develop further mental or somatic illnesses (sequential comorbidity).
Methods
This review is based on pertinent publications retrieved by a selective search in PubMed.
Results
The group of anxiety disorders includes generalized anxiety disorder (GAD), phobic disorders, panic disorders, and two disorders that are often restricted to childhood—separation anxiety and selective mutism. A comprehensive differential diagnostic evaluation is essential, because anxiety can be a principal manifestation of other types of mental or somatic illness as well. Psychotherapy and treatment with psychoactive drugs are the therapeutic strategies of first choice. Of all types of psychotherapy, cognitive behavioral therapy has the best documented efficacy. Modern antidepressants are the drugs of first choice for the treatment of panic disorders, agoraphobia, social phobia, and GAS; pregabalin is a further drug of first choice for GAS.
Conclusion
In general, anxiety disorders can now be effectively treated. Patients should be informed of the therapeutic options and should be involved in treatment planning. Current research efforts are centered on individualized and therefore, it is hoped, even more effective treatment approaches than are available at present.
Anxiety is a a normal and necessary basic emotion without which individual survival would be impossible. Pathologically increased anxiety can arise not only in anxiety disorders per se, but also in most other types of mental illness. Anxiety can also be a warning signal of potential harm in somatic illnesses, such as myo-cardial infarction or hypoglycemia in a diabetic patient; it naturally requires an entirely different therapeutic approach in such situations. For any patient presenting with pathologically increased anxiety, a thorough psychiatric and somatic evaluation is needed so that an underlying pulmonary (e1), cardiovascular (e2), neurological (e3), or endocrine disease (e.g., of the thyroid gland) (e4) can be ruled out. Anxiety reactions as such are important indicators of a possible threat to homeostasis; anxiety is considered a disease requiring treatment when it arises in the absence of any threat, or in disproportionate relation to a threat, and keeps the affected individual from leading a normal life.
Anxiety is a normal emotion. It’s your brain’s way of reacting to stress and alerting you of potential danger ahead.
Everyone feels anxious now and then. For example, you may worry when faced with a problem at work, before taking a test, or before making an important decision.
Occasional anxiety is OK. But anxiety disorders are different. They’re a group of mental illnesses that cause constant and overwhelming anxiety and fear. The excessive anxiety can make you avoid work, school, family get-togethers, and other social situations that might trigger or worsen your symptoms.
