[Anxiety disorders: which psychotherapy for whom?]

Area of Science:

• Psychiatry and Psychology
• Public Health

Background:

• Anxiety disorders are prevalent, affecting approximately 15% of the German population annually.
• Women are disproportionately affected, with twice the incidence compared to men.
• Key anxiety disorders assessed include panic disorder, agoraphobia, generalized anxiety disorder, social anxiety disorder, and specific phobias.

Purpose of the Study:

• To review the literature on the most suitable psychotherapies for anxiety disorders.
• To determine the most promising psychotherapy for individual patients and specific diagnoses.
• To identify optimal strategies for managing treatment nonresponse or avoidance.

Main Methods:

• Systematic literature review based on national and international guidelines.
• Assessment of evidence for different psychotherapy modalities.
• Analysis of recommendations for treatment selection and management of nonresponse.

Main Results:

• Cognitive behavioral therapy (CBT) is the first-line psychotherapy for most anxiety disorders.
• Psychodynamic therapy and pharmacotherapy are recommended alternatives when CBT is ineffective or unavailable.
• Empirical evidence for individualized treatment recommendations and specific strategies for non-responders is limited.

Conclusions:

• CBT is the recommended initial psychotherapy for anxiety disorders.
• Alternative treatments exist for non-responders, though evidence-based individual recommendations are lacking.
• Clinical consensus guides preferred strategies for managing treatment challenges in anxiety disorders.