The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management.

Journal: World psychiatry : official journal of the World Psychiatric Association (WPA)

Volume: 20

Issue: 3

Year of Publication: 

Affiliated Institutions:  South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, (UCLA), Los Angeles, CA, USA. Department of Psychiatry, Emory University, Atlanta, GA, USA. Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and Southern Health NHS Foundation Trust, Southampton, UK. School of Life and Medical Sciences, University of Hertfordshire, and Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK. Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, The Netherlands. Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.

Abstract summary 

The clinical construct of "anxiety neurosis" was broad and poorly defined, so that the delineation of specific anxiety disorders in the DSM-III was an important advance. However, anxiety and related disorders are not only frequently comorbid, but each is also quite heterogeneous; thus diagnostic manuals provide only a first step towards formulating a management plan, and the development of additional decision support tools for the treatment of anxiety conditions is needed. This paper aims to describe systematically important domains that are relevant to the personalization of management of anxiety and related disorders in adults. For each domain, we summarize the available research evidence and review the relevant assessment instruments, paying special attention to their suitability for use in routine clinical practice. We emphasize areas where the available evidence allows the clinician to personalize the management of anxiety conditions, and we point out key unmet needs. Overall, the evidence suggests that we are becoming able to move from simply recommending that anxiety and related disorders be treated with selective serotonin reuptake inhibitors, cognitive-behavioral therapy, or their combination, to a more complex approach which emphasizes that the clinician has a broadening array of management modalities available, and that the treatment of anxiety and related disorders can already be personalized in a number of important respects.

Authors & Co-authors:  Stein Dan J DJ Craske Michelle G MG Rothbaum Barbara O BO Chamberlain Samuel R SR Fineberg Naomi A NA Choi Karmel W KW de Jonge Peter P Baldwin David S DS Maj Mario M

Study Outcome 

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Statistics
Citations :  Baxter AJ, Scott KM, Vos T et al. Global prevalence of anxiety disorders: a systematic review and meta‐regression. Psychol Med 2013;43:897‐910.
Authors :  9
Identifiers
Doi : 10.1002/wps.20919
SSN : 1723-8617
Study Population
Male,Female
Mesh Terms
Other Terms
Anxiety;anxiety and related disorders;clinical subtypes;dysfunctional cognitive schemas;early environmental exposures;family history;functioning;neurocognition;obsessive-compulsive disorder;personality traits;personalization of treatment;physical comorbidities;post-traumatic stress disorder;protective factors;psychiatric antecedents;psychiatric comorbidities;quality of life;recent environmental exposures;severity;symptom profile
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
Italy