[Anxiety: personality, life style or illness?]

The nosology of anxiety disorders has been several times modified during the last years, but some important questions in this field still remain unresolved. The threshold between anxiety disorders and normal or physiological anxious states is often difficult to formally describe. Epidemiological studies do show that important variations of prevalence rates can be obtained by little modifications of diagnostic criteria. Generalized anxiety disorder and social phobia for example must be defined by severity and impairment criteria, adequately demanding to distinguish actual pathology from normal states or particular life styles. The other point is the distinction between anxiety disorders and personality traits or disorders. Only a few epidemiological studies have addressed this issue, but two models can be used: first categorical definitions of personality disorders (e.g. avoidant, dependent, or anankastic personality disorders), and second main personality traits such as neuroticism, behavioral inhibition, or trait-anxiety. Clinical epidemiological surveys and longitudinal studies may lead to significant progress in the comprehension of these problems.