[Diagnosis, epidemiology and comorbidity of anxiety disorders]

Fears and apprehensions which significantly impair a person's everyday life and which cannot be attributed to an organic brain disturbance or to other mental disorders or physical problems are grouped together in the class of "anxiety disorders". Three types of anxiety disorders can be distinguished on the basis of clinical picture and the course of development of symptoms: phobias, panic disorder and generalized anxiety disorder. Recent epidemiological studies indicate that anxiety disorders are one of the most common kinds of mental disorder. More than a fourth of the persons surveyed in a general population have suffered from an anxiety disorder at some point in their lives. Phobias occur most frequently, with social phobias being the most common according to the latest studies (lifetime prevalence of 13.3% to 16%). The lifetime prevalence of panic disorder is estimated at 1.2% to 3.5%, depending on the diagnostic system (DSM-III-R, ICD-10) and survey instruments used. Generalized anxiety disorder is estimated to have a lifetime prevalence of between 1.9% and 6.6%. Overall, anxiety disorders tend to occur more often in women than in men. Onset is usually in childhood or adolescence. All anxiety disorders have a high lifetime comorbidity with other mental disorders. The frequency of anxiety disorders occurring in combination with affective disorders and substance abuse and dependence over the span of a lifetime is significantly high. Increased risk of suicide is an important factor to consider when assessing these patients, especially in the case of panic disorder or social phobias.