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Generalized anxiety disorder. An important clinical concern
1Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA.
The Medical Clinics of North America
|May 15, 2001
Summary
Generalized Anxiety Disorder (GAD) is chronic and often presents with somatic symptoms in primary care. Effective treatments include cognitive-behavioral therapy and newer antidepressants, with ongoing research into their long-term benefits.
Area of Science:
- Psychiatry
- Neuroscience
Background:
- Generalized Anxiety Disorder (GAD) is a prevalent, chronic mental health condition.
- GAD frequently co-occurs with other psychiatric and medical disorders.
- It often presents with somatic symptoms in primary care settings.
Purpose of the Study:
- To review the presentation and treatment of GAD in primary care.
- To discuss the neurobiological underpinnings of GAD.
- To evaluate current and emerging pharmacotherapies and psychotherapies for GAD.
Main Methods:
- Literature review of GAD epidemiology, neurobiology, and treatment modalities.
- Analysis of evidence supporting cognitive-behavioral therapy (CBT) and pharmacotherapy.
- Discussion of treatment considerations for comorbid conditions.
Main Results:
- Cognitive therapy combined with relaxation or anxiety management training shows low relapse rates.
- Newer antidepressants targeting serotonin and norepinephrine may effectively treat GAD and comorbid depression.
- The efficacy of certain anticonvulsants for GAD requires further investigation.
Conclusions:
- Primary care physicians need awareness of GAD's presentation and treatment options.
- Antidepressants may offer advantages over benzodiazepines due to lower addiction and withdrawal risks.
- Further research is needed to compare CBT and pharmacotherapy effectiveness and long-term outcomes in GAD.
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