Anxiety disorders: classification and diagnosis

Obsessive-Compulsive Disorder and Panic Disorder with or without agoraphobia are emphasized as specific entities that are easily accessible to pharmacological treatment, while more unspecific and heterogeneous syndromes are less predictable in their reaction to treatment. The DSM-III system, not yet official in Sweden, is described and commented on. Agoraphobia has undergone a re-evaluation and should be coupled with Panic Disorder, although the two illness components may have somewhat different genetic and biochemical mechanisms. Obsessive-Compulsive Disorder, on the other hand, should not be listed under Anxiety States, but have a place of its own. The relationship between anxiety and depression is discussed, and it is suggested that there is a clear break between specific affective disorders and specific anxiety disorders, while there may be continuity between Generalized Anxiety and Neurotic-reactive (dysthymic) depression, with mixed cases in between. Still, much work needs to be done in the classification of these disorders.