Assessment and treatment of pervasive anxiety

Definitions of the central symptoms of anxiety disorders are given and these are followed by the principles underlying assessment; a discussion of rating scales for the detection and measurement of morbid degrees of anxiety follows. The important points in assessment prior to therapy are outlined and emphasis is placed on the possibility of distinguishing biogenic (endogenous) anxiety states from the more usual psychogenic forms of anxiety disorder. This distinction is of major importance when devising the therapeutic plan: biogenic depressive states, of which the early stage of panic disorder is one form, are resistant to psychotherapeutic intervention but may respond to treatment with antidepressant drugs. The principles of brief psychotherapeutic intervention are outlined with emphasis on the two central themes underlying successful therapy: the development of self-control and the exposure of the patient to anxiety in the setting of the therapeutic programme.