Generalized Anxiety Disorder and Panic Disorder in Adults.

Area of Science:

• Primary care
• Mental health
• Anxiety disorders

Background:

• Generalized anxiety disorder (GAD) and panic disorder (PD) are prevalent in adult primary care.
• Screening for PD and GAD lacks universal evidence but is indicated for specific patient groups.
• Concurrent substance use disorders are common and require integrated treatment.

Purpose of the Study:

• To outline evaluation and treatment strategies for GAD and PD in primary care.
• To highlight appropriate screening tools and therapeutic interventions.
• To provide guidance on medication use and prevention.

Main Methods:

• Review of evidence for screening, diagnosis, and treatment of GAD and PD.
• Identification of validated screening tools: GAD-7 and Patient Health Questionnaire for PD.
• Analysis of therapeutic options including cognitive behavior therapy, antidepressants, and pharmacotherapy.

Main Results:

• Evaluation is advised for patients with pervasive worry or unexplained somatic symptoms.
• GAD-7 and Patient Health Questionnaire are effective screening tools.
• Cognitive behavior therapy and antidepressants (SSRIs, SNRIs) are first-line treatments.
• Benzodiazepines are not recommended for initial or long-term therapy due to risks.
• Exercise may offer some benefit, but specific prevention strategies lack consistent evidence.

Conclusions:

• Primary care physicians should consider evaluating patients for GAD and PD.
• Validated screening tools can aid in diagnosis and assessment.
• Integrated treatment for co-occurring substance use disorders is crucial.
• Pharmacological and non-pharmacological interventions should be carefully selected, prioritizing safety and efficacy.