[Anxiety Disorders in Rehabilitation]

Area of Science:

• Psychiatry
• Rehabilitation Medicine
• Clinical Psychology

Background:

• Anxiety disorders are prevalent and socio-medically significant mental illnesses.
• Effective diagnosis and therapy are crucial for patient prognosis and social participation.
• Rehabilitation is vital for managing anxiety disorders and preventing chronification.

Purpose of the Study:

• To provide an overview of new developments in anxiety disorders relevant to rehabilitation.
• To highlight changes in ICD-11 classification and S3 guideline recommendations.
• To discuss the role of various therapeutic approaches, including digital options, in rehabilitation settings.

Main Methods:

• Review of recent literature and guideline updates concerning anxiety disorders.
• Analysis of therapeutic modalities including psychotherapy, pharmacotherapy, and digital interventions.
• Examination of the integration of anxiety disorder treatment within rehabilitation frameworks.

Main Results:

• ICD-11 introduces an independent chapter for anxiety disorders.
• Revised S3 guideline (2020) incorporates digital therapy options like virtual reality exposure therapy (VER) and internet-supported methods.
• Systemic therapy is newly considered, though evidence for digital and systemic therapies is less robust than for established methods like cognitive behavioral therapy (CBT).

Conclusions:

• Online interventions are not recommended as standalone therapies.
• Rehabilitation settings are crucial for recognizing comorbid anxiety disorders and providing integrated treatment.
• Cognitive behavioral therapy (CBT) remains the first-line psychotherapy, with careful consideration of somatic comorbidities and pharmacotherapy contraindications.