[The generalized anxiety disorder--disease pattern, diagnostics and therapy].

Area of Science:

• Psychiatry
• Clinical Psychology

Background:

• Generalized Anxiety Disorder (GAD) is a prevalent anxiety disorder characterized by chronicity and significant psychosocial impairment.
• GAD is often underdiagnosed due to less dramatic symptoms and evolving diagnostic criteria (DSM-IIIR, ICD-10).
• Historically, research on GAD, particularly psychotherapy, has been limited.

Purpose of the Study:

• To review the diagnostics, epidemiology, and current psychotherapy research for GAD.
• To highlight the need for further research into psychodynamic therapy for GAD.
• To present an ongoing randomized controlled trial comparing psychodynamic therapy and CBT for GAD.

Main Methods:

• Review of existing literature on GAD diagnostics, epidemiology, and psychotherapy.
• Description of an ongoing randomized controlled trial (RCT).
• The RCT compares manualized psychodynamic therapy with cognitive-behavioral therapy (CBT) for GAD.

Main Results:

• Cognitive-behavioral therapy (CBT) is recognized as an empirically supported treatment for GAD.
• Controlled, manualized studies on psychodynamic therapy for GAD are currently lacking.
• Preliminary results for psychodynamic therapy in GAD are promising, warranting further investigation.

Conclusions:

• There is a clear need for more rigorous research on psychodynamic therapy for GAD.
• An ongoing RCT is evaluating the efficacy and mechanisms of change for both psychodynamic therapy and CBT in GAD.
• Mechanisms of change being investigated include fearful cognitions and Core Conflictual Relationship Themes.