- Last edited on February 26, 2021
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====== Anxiety Disorders ====== | ====== Anxiety Disorders ====== | ||
+ | ===== Primer ===== | ||
<WRAP group> | <WRAP group> | ||
<WRAP half column> | <WRAP half column> | ||
- | ===== Primer ===== | + | **Anxiety Disorders** are a group of mental disorders characterized by significant feelings of anxiety and fear, including generalized anxiety disorders, specific phobias, panic disorder, and posttraumatic stress disorder. Anxiety is a worry about future events, and fear is a reaction to current events. These feelings may cause significant somatic symptoms as well. |
- | **Anxiety Disorders** are a group of mental disorders characterized by significant feelings of anxiety and fear. Anxiety is a worry about future events, and fear is a reaction to current events. These feelings may cause physical symptoms, such as a fast heart rate and shakiness. | + | </WRAP> |
+ | <WRAP half column> | ||
+ | <catlist anxiety: -columns:1 -noAddPageButton -sortAscending -noNSInBold> | ||
+ | </WRAP> | ||
+ | </WRAP> | ||
- | ==== Prevalence by Age ==== | + | == Epidemiology == |
- | <imgcaption image1|>{{:anxiety:anxiety-disorders-over-lifetime.jpg?direct|Changes in anxiety disorder presentation across the lifespan. (Dialogues Clin Neurosci. 2011 Dec; 13(4): 381–399.)}}</imgcaption> | + | * The lifetime prevalence rates of anxiety disorders is as high as 31%.[([[https://pubmed.ncbi.nlm.nih.gov/25081580/|Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., & Van Ameringen, M. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC psychiatry, 14(1), 1-83.]])] |
+ | == Prognosis == | ||
+ | * Anxiety disorders can cause substantial functional impairment, quality of life issues, decreased work productivity, and a significant economic impact.[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4994788/|MacQueen, G. M., Frey, B. N., Ismail, Z., Jaworska, N., Steiner, M., Lieshout, R. J., Kennedy, S. H., Lam, R. W., Milev, R. V., Parikh, S. V., Ravindran, A. V., & CANMAT Depression Work Group (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 6. Special Populations: Youth, Women, and the Elderly. Canadian journal of psychiatry, 61(9), 588–603.]])] | ||
+ | |||
+ | == Comorbidity == | ||
+ | * Anxiety disorders are most associated with developing a comorbid [[mood:1-depression:home|major depressive disorder]]. | ||
+ | |||
+ | == Risk Factors == | ||
+ | * A family history of anxiety disorders, personal history of stressful life events | ||
+ | * Women have higher rates for most anxiety disorders compared to men.[([[https://pubmed.ncbi.nlm.nih.gov/25081580/|Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., & Van Ameringen, M. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC psychiatry, 14(1), 1-83.]])] | ||
+ | |||
+ | ===== Average Age of Onset ===== | ||
+ | The average age of onset varies greatly between anxiety disorders.[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407545/|Lijster, J. M., Dierckx, B., Utens, E. M., Verhulst, F. C., Zieldorff, C., Dieleman, G. C., & Legerstee, J. S. (2017). The Age of Onset of Anxiety Disorders. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 62(4), 237–246.]])] | ||
+ | |||
+ | <WRAP group> | ||
+ | <WRAP half column> | ||
+ | <panel type="info" title="Average Age of Onset" subtitle="Adapted from: Lijster, J. M et al. (2017). The Age of Onset of Anxiety Disorders. Canadian journal of psychiatry. 62(4), 237–246." no-body="true" footer=""> | ||
+ | <mobiletable 1> | ||
+ | ^ ^ Average age ^ Range ^ | ||
+ | ^ Separation anxiety disorder | 11 years | 6 to 14 | | ||
+ | ^ Specific phobia | 11 years | 8 to 14 | | ||
+ | ^ Social anxiety disorder (social phobia) | 14 years | 13 to 15 | | ||
+ | ^ Agoraphobia without panic disorder | 21 years | 17 to 25 | | ||
+ | ^ Obsessive-compulsive disorder | 24 years | 19 to 29 | | ||
+ | ^ Posttraumatic stress disorder | 27 years | 22 to 31 | | ||
+ | ^ Panic disorder | 30 years | 26 to 35 | | ||
+ | ^ Generalized anxiety disorder | 35 years | 31 to 39 | | ||
+ | </mobiletable> | ||
+ | </panel> | ||
</WRAP> | </WRAP> | ||
<WRAP half column> | <WRAP half column> | ||
- | ===== Anxiety Disorders ===== | + | <imgcaption image1|> |
- | ~~DIR:anxiety&noheader~~ | + | {{:anxiety:anxiety-disorders-over-lifetime.jpg?direct|Changes in anxiety disorder presentation across the lifespan. (Dialogues Clin Neurosci. 2011 Dec; 13(4): 381–399.)}} |
+ | </imgcaption> | ||
</WRAP> | </WRAP> | ||
</WRAP> | </WRAP> | ||
+ | |||
+ | ==== Older Adults ==== | ||
+ | * Late onset anxiety disorders are relatively unusual. Thus, older patients with new onset anxiety symptoms should always have a thorough investigation for other etiologies including physical illness and medication side effects.[([[https://pubmed.ncbi.nlm.nih.gov/25081580/|Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., & Van Ameringen, M. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC psychiatry, 14(1), 1-83.]])] | ||
+ | |||
+ | ===== Treatment ===== | ||
+ | * The treatment of most anxiety disorders can broadly be divided into pharmacological and psychological therapies. | ||
+ | * Cognitive behavioural therapy is the primary treatment modality, with some modifications for specific disorders. | ||
+ | * Regardless of whether one takes a medication, guidelines recommend that gradual exposure to fears should be done (i.e. - exposure to decreased avoidance behaviours).[([[https://pubmed.ncbi.nlm.nih.gov/25081580/|Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., & Van Ameringen, M. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC psychiatry, 14(1), 1-83.]])] | ||
+ | |||
+ | |||
===== Resources ===== | ===== Resources ===== | ||
- | == Research == | + | == For Providers == |
+ | * **[[https://www.nature.com/articles/nrdp201724|Craske, M., Stein, M., Eley, T. et al. Anxiety disorders. Nat Rev Dis Primers 3, 17024 (2017).]]** | ||
* [[https://www.ncbi.nlm.nih.gov/pubmed/22275845|Lenze, E. J., & Wetherell, J. L. (2011). A lifespan view of anxiety disorders. Dialogues in clinical neuroscience, 13(4), 381.]] | * [[https://www.ncbi.nlm.nih.gov/pubmed/22275845|Lenze, E. J., & Wetherell, J. L. (2011). A lifespan view of anxiety disorders. Dialogues in clinical neuroscience, 13(4), 381.]] | ||
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- | {{tag>anxiety-main}} |