[Possibilities in therapy of anxiety disorders in DSM-III-R]

Between 2% and 5% of the population are affected by anxiety disorders. Several studies have shown that imipramine possesses anti-panic and anti-phobic properties. Its response rate is at least 70%. In panic disorder with agoraphobia it is therefore the medication of first choice. Agoraphobia, simple and social phobias are highly responsive to behavioural therapy (desensitization, flooding, social skills training, cognitive restructuring). Drugs have not been found useful in controlled studies. In conjunction with the tricyclic antidepressant clomipramine, behavioural therapy is superior to other psychotherapeutic strategies in the treatment of obsessive-compulsive disorders. Patients suffering from posttraumatic stress disorders require first of all supportive psychotherapy. Pharmacological treatment is of limited value. Neuroleptics, benzodiazepines, sedating antidepressants and beta-blockers are the most appropriate agents for the treatment of generalised anxiety disorders. In addition to that, intense psychotherapy and relaxation techniques should be applied. Further research should address the question of relapse rates after termination of therapy and the elaboration of therapeutic strategies that take individual psychopathology into consideration.