RESEARCH OUTLINE 2 Anxiety Disorders – Research Outline I. ABSTRACT II. INTRODUCTION TO ANXIETY DISORDERS III. AN OVERVIEW OF ANXIETY DISORDERS A. Social Anxiety Disorder B. Generalized Anxiety Disorder C. Panic Disorder D. Agoraphobia E. Separation Anxiety Disorder F. Selective Mutism IV. POTENTIAL CAUSES A. Genetic 1. Anxiety disorders Aug 18, · Anxiety Disorders Anxiety disorders are a group of mental disorders characterized by constant overwhelming apprehension and fear. Unlike the usual temporary anxiety, people with anxiety disorders are incessantly worried and their nervousness often affects their ability to function in social and occupational interactions ANXIETY DISORDERS 3 INTRODUCTION This paper is intended to give an overview of anxiety disorders as presented by DSM-5 (APA, ) and other related research. Its primary purpose is to give the reader an understanding of anxiety disorders, their causes, how to evaluate them and finally how to treat said disorders
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Try out PMC Labs and tell us what you think. Learn More. Language: English Spanish French. Anxiety disorders are often underrecognized and undertreated in primary care. Treatment is indicated when a patient shows marked distress or suffers from complications resulting from the disorder. The treatment recommendations given in this article are based on guidelines, meta-analyses, and systematic reviews of randomized controlled studies.
Anxiety disorders should be treated with psychological therapy, pharmacotherapy, or a combination of both. Cognitive behavioral therapy can be regarded as the psychotherapy with the highest level of evidence.
First-line drugs are the selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Benzodiazepines are not recommended anxiety disorders research paper routine use.
Other treatment options include pregabalin, tricyclic antidepressants, buspirone, moclobemide, and others, anxiety disorders research paper. After remission, medications should be continued for 6 to 12 months. When developing a treatment plan, efficacy, adverse effects, interactions, costs, and the preference of the patient should be anxiety disorders research paper. Los trastornos de ansiedad trastorno de ansiedad generalizada, trastorno de pánicolagorafobia, trastorno de ansiedad anxiety disorders research paper y otros son los trastornos psiquiátricos más prevalentes y están asociados con una alta carga de enfermedad.
En la atención primaria los trastornos de ansiedad tienen a menudo un bajo reconocimiento y son subtratados. La terapia se indica cuando un paciente muestra un marcado distrés causado por el trastorno o sufre por complicaciones debidas a él. Las recomendaciones terapéuticas que se entregan en este artículo están basadas en guías clínicas, estudios de meta-análisis, revisiones sistemáticas y estudios controlados randomizados.
Los trastornos de ansiedad deben ser tratados con terapia psicológica, farmacoterapia ylo una combinacíon de ambas. Anxiety disorders research paper terapia cognitivo conductual puede ser considerada la psicoterapia con el mayor nivel de evidencia. No se recomiendan las benzodiacepinas para un empleo rutinario. Otras opciones terapéuticas incluyen pregabalina, antidepresivos tricíclicos, buspirona, moclobemide y otros.
Después de la remisión, los medicamentos deben continuarse por unos 6 a 12 meses. Cuando se desarrolla un plan terapéutico se debe considerar la eficacia, los efectos adversos, las interacciones, los costos y la preferencia del paciente. Les troubles anxieux sont souvent peu reconnus et peu traités en soins primaires, anxiety disorders research paper.
Le traitement est indiqué quand ces troubles causent une détresse manifeste chez le patient ou lorsqu'il souffre de complications. Les conseils de traitement donnés dans cet article sont basés sur des recommandations, des métaanalyses et des revues systématiques d'études contrôlées randomisées, anxiety disorders research paper. Les troubles anxieux doivent être soignés par un traitement psychologique, une pharmacothérapie, ou une association des deux.
Le traitement cognitivo-comportemental est considéré comme la psychothérapie ayant niveau de preuve le plus élevé. Les inhibiteurs sélectifs de la recapture de la sérotonine et les inhibiteurs de la recapture de la sérotonine et de la noradrénaline sont les médicaments de première ligne. Les benzodiazépines ne sont pas recommandées en routine, anxiety disorders research paper. La prégabaline, les antidépresseurs tricycliques, la buspirone, le moclobémide et d'autres sont d'autres traitements possibles.
Les médicaments doivent être poursuivis 6 à 12 mois après la rémission. Lors de l'élaboration d'un plan de traitement, il faut tenir compte de l'efficacité, des effets indésirables, du coût et de la préférence du patient.
Anxiety disorders are the most prevalent psychiatric disorders and are associated with a high burden of illness. Panic disorder with or without agoraphobia PDA is the next most common type with a prevalence of 6. Evidence is lacking on whether these disorders have become more frequent in recent decades, anxiety disorders research paper.
The age of onset for anxiety disorders differs among the disorders. Separation anxiety disorder and specific phobia start during childhood, with anxiety disorders research paper median age of onset of 7 years, anxiety disorders research paper, followed by SAD 13 yearsagoraphobia without panic attacks 20 yearsand panic disorder 24 years. Anxiety disorders tend to run a chronic course, with symptoms fluctuating in severity between periods of relapse and remission in GAD and PDA 9 and a more chronic course in SAD.
After the age of 50, a marked decrease in the prevalence of anxiety disorders has been observed in epidemiological studies. The current conceptualization of the etiology of anxiety disorders includes an interaction of psychosocial factors, eg, childhood adversity, stress, or trauma, and a genetic vulnerability, which manifests in neurobiological and neuropsychological dysfunctions.
The evidence for potential biomarkers for anxiety disorders in the fields of neuroimaging, genetics, neurochemistry, neurophysiology, and neurocognition has been summarized in two recent consensus papers.
Thus, it is difficult to give recommendations for specific biomarkers eg, genetic polymorphisms that could help identify persons at risk for an anxiety disorder. Obsessive-compulsive disorder OCD and post-traumatic stress disorder PTSD were formerly included in the anxiety disorders, but have now been placed in other chapters in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders DSM Therefore, OCD and PTSD are not discussed in this review.
A short description of the anxiety disorders is given in Table I. Anxiety disorders are often underdiagnosed in primary care. In DSM-5the group of anxiety disorders has been expanded to include separation anxiety disorder, a diagnosis the previous DSM version reserved for children only.
Illness anxiety disorder was formerly called hypochondriasis in DSM-IV and Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems ICD ; in DSM-5it is not classified under anxiety disorders but belongs to the Somatic Symptom and Related Disorders category.
In the current ICD Beta Draft, 19 hypochondriasis is placed in the group Obsessive-Compulsive or Related Disorders. It is characterized by catastrophic misinterpretation of bodily symptoms and is manifest as obsessive and excessive health-related behaviors, anxiety disorders research paper. The fear of having a serious medical condition persists despite thorough medical evaluation and repeated reassurance that the patient does not suffer from the feared illness. Mixed anxiety disorders research paper and depression is a category listed only in ICD and not in DSM It is often diagnosed in primary care.
Research on the treatment of this disorder is limited. It occurs as a reaction to stressful life events. The differential diagnosis of anxiety disorders includes common mental disorders, such as other anxiety disorders, major depression, and somatic symptom disorders, as well as physical illnesses such as coronary heart or lung diseases, hyperthyroidism, anxiety disorders research paper, and others.
Anxiety disorders often co-occur with other anxiety disorders, major depression, anxiety disorders research paper, somatic symptom disorders, personality disorders, and substance abuse disorders. Box 1 contains a case vignette of the treatment anxiety disorders research paper a patient with GAD. Alice, a year-old female dentist, presented to a psychiatrist with a 7-month history of anxiety symptoms, which included persistent feelings of restlessness, irritability, difficulty concentrating, sleep disturbance, fatigue, nausea, diarrhea, muscle cramps, and the sensation of having a lump in her throat.
She was suffering from constant worry that her husband could become ill or might have an accident while driving to work, anxiety disorders research paper. Her symptoms resulted in frequent absenteeism, which caused significant problems at work. Her medical history was unremarkable. The psychiatrist diagnosed her with generalized anxiety disorder, DSM-5 F Four weeks previously, Alice had been prescribed the benzodiazepine diazepam by her general practitioner, and initially took it as prescribed.
Although it helped with her anxiety, she felt that it made her feel dull and worried that it would interfere with her work as a dentist. She kept thinking that she would become addicted to the drug and stopped the intake. The psychiatrist started treatment with the serotonin-norepinephrine reuptake inhibitor venlafaxine. Because the patient was sensitive anxiety disorders research paper side effects, the drug was started with She reported mild nausea and fatigue; however, it was not clear whether this was due to the medication or to the illness.
The patient also received weekly sessions of cognitive behavioral therapy. Symptoms of GAD were resolved almost completely after 7 weeks. The psychiatrist advised Alice to continue on venlafaxine for at least 6 months. Then, after 2 weeks on The patient did not report relevant anxiety disorders research paper symptoms and did no show reoccurrence of significant anxiety symptoms during a follow-up observation period of almost 1 year.
In clinical settings, most patients seeking help suffer from GAD, PDA, and SAD. However, treatment is indicated when a patient shows marked distress or suffers from complications resulting from the disorder eg, secondary depression, suicidal ideation, anxiety disorders research paper, or alcohol abuse.
Anxiety disorders can be treated mostly on an outpatient basis. Indications for hospitalization include suicidality, unresponsiveness to standard treatments, or relevant comorbidity, eg, with major depression, personality disorders, or substance abuse. The treatment recommendations in this article are based on guidelines for anxiety disorders. Studies were analyzed by using internationally acknowledged quality assessment tools, and the recommendations were reviewed by expert panels.
Patients with different anxiety disorders show anxiety disorders research paper degrees of health care utilization. For example, in the United States, There is evidence for substantial undertreatment of anxiety disorders. In a large European study, only Of those participants who contacted health care services, The treatment plan should include psychotherapy, pharmacotherapy, anxiety disorders research paper, and other interventions, which should be chosen after careful consideration of individual factors, eg, the patient's preference, the patient's history with previous treatment attempts, illness severity, comorbidities such as personality disorders, suicidally, local availability of treatment methods, wait time for psychotherapy appointments, costs, and other factors.
Whereas many anxiety disorders research paper have shown the efficacy of medications for GAD, PDA, and SAD, there are very few studies on drug treatment for specific phobias, for example, there is a small study suggesting the efficacy of paroxetine. However, not all drugs mentioned here are licensed for anxiety indications in all countries, and the reader should refer to local prescribing information, anxiety disorders research paper. Table III lists drug side effects. For a detailed list of available randomized controlled studies, the reader should refer to guidelines published by Bandelow et al, 2733 which include a systematic evaluation of available studies.
Patients should be informed that the onset of the anxiolytic effect of these antidepressants has a latency of 2 to 4 weeks in some cases up to 6 weeks, anxiety disorders research paper. During the first 2 weeks, adverse effects may be stronger. Initial jitteriness or an increase in anxiety symptoms may occur, which may reduce the patients' treatment compliance. Lowering the starting dose of the antidepressants may reduce these adverse effects.
A review of studies in depressed patients suggested that SNRIs may be less well tolerated than the SSRIs. Some SSRIs and SNRIs are inhibitors of cytochrome P enzymes and hence may interact with other psychopharmacological drugs and medications for medical illnesses.
However, these are anxiety disorders research paper less frequent and severe than the withdrawal reactions observed after terminating benzodiazepine treatment. These adverse reactions may be more frequent with paroxetine than with sertraline or fluoxetine.
Introduction to anxiety and anxiety child anxiety disorders
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Jun 17, · Anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, social anxiety disorder, and others) are the most prevalent psychiatric disorders, and are associated with a high burden of illness. Anxiety disorders are often underrecognized and Cited by: This study examined the association among childhood history of anxiety disorders, current anxiety symptoms, and anxiety sensitivity in a sample of patients with panic disorder undergoing treatment. Fifty-five percent of the patients had histories of one or more childhood anxiety disorders ANXIETY DISORDERS 3 INTRODUCTION This paper is intended to give an overview of anxiety disorders as presented by DSM-5 (APA, ) and other related research. Its primary purpose is to give the reader an understanding of anxiety disorders, their causes, how to evaluate them and finally how to treat said disorders
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