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Morbid Anxiety: Identification and Treatment.

Andrew W Goddard¹

¹Dr. Goddard is professor of psychiatry with the University of California, San Francisco, Fresno Medical Education and Research Program, Fresno.

Focus (American Psychiatric Publishing)

|January 25, 2020

Summary

Anxiety disorders are a major public health issue, often underdiagnosed and undertreated despite available therapies. This review covers diagnostic updates, evidence-based treatments, and future directions for anxiety management.

Keywords:

DSM-5 anxiety anti-anxiety pharmacotherapy anxiety assessment anxiety disorders brief dynamic psychotherapy cognitive-behavioral therapy

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Area of Science:

Psychiatry
Clinical Psychology
Public Health

Background:

Anxiety disorders represent a significant public health challenge due to their high prevalence and chronic nature.
Despite established diagnostic criteria and effective treatments, many patients with anxiety disorders remain undiagnosed or undertreated.

Purpose of the Study:

To synthesize current clinical knowledge on anxiety disorders.
To highlight diagnostic changes introduced by the DSM-5.
To review evidence-based treatments and explore emerging therapeutic strategies.

Main Methods:

Clinical synthesis of existing literature.
Review of diagnostic criteria and treatment guidelines.
Discussion of pharmacological, psychotherapeutic, and novel treatment modalities.

Main Results:

The DSM-5 introduced changes impacting anxiety disorder diagnosis.
Evidence supports selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, cognitive-behavioral therapy (CBT), and dynamic therapies.
Emerging treatments include cognitive enhancement, complementary therapies, and neuromodulation.

Conclusions:

Accurate diagnosis and effective treatment of anxiety disorders require ongoing clinical attention.
Future directions involve refining nosology through initiatives like the NIMH Research Domain Criteria (RDoC) and advancing personalized medicine approaches.