In coeliac disease, affective disorders should be ascribed to difficulties in adjusting to the chronic nature of the disease rather than directly to the disease itself, thus giving an indication for preventive liaison psychiatric interventions.

Word count: 2754 2 ABSTRACT:Background -Although previous studies demonstrated an association between depressive

Anxiety disorders impose a significant economic burden on healthcare system, patients and society as a whole. A patient with anxiety disorders, especially with panic disorder, shows some difficulties to work or to maintain an acceptable social functioning, and, frequently, needs more medical care than a normal subject, often due to unnecessary or inappropriate diagnostic tests. Adequate psychiatric treatment of anxiety disorders can lead to higher direct specialists costs (psychiatric drugs and visits) but this may be offset by a decrease in non-specialist care costs and in indirect costs. Benzodiazepines have been extensively used for the treatment of anxiety and related disorders since the 1960s. Although new pharmacological and psychological treatments for anxiety are available, a lot of psychiatrists continue to endorse benzodiazepines as primary or adjunctive treatment for these disturbs, especially in the early or acute phases of the illness. In Italy, benzodiazepines have been available also as generic drugs for some years. In order to be accepted for marketing, a generic drug has to demonstrate bioequivalence, considered a reliable proxy of therapeutic equivalence, with the standard formulation and its price has to be at least 20% cheaper than the originator drug. The use of generic drugs can contain drug expenditures and facilitate a competitive market. Despite that their prices are considerably higher than those of generics, branded benzodiazepines are still widely prescribed, because of prejudices and lack of information in the community of physicians and patients. In conclusion, benzodiazepines may treat anxiety disorders, mainly in early and acute phases, increasing quality of life and saving medical resources. The availability of generics allows for marginal reduction in initial investment in drug costs. Keywords INTRODUZIONELa stima della prevalenza delle patologie legate all'ansia risulta notevolmente complicata, soprattutto a causa della frequente comorbidità di disturbi d'ansia diversi (disturbo d'ansia generalizzato, attacchi di panico) e di disturbi depressivi [1]. Inoltre, le scale di misurazione utilizzate negli studi epidemiologici sono spesso poco affidabili [2]. Nel complesso, i disturbi d'ansia colpiscono circa il 25% delle persone nell'arco della loro vita [3,4].Uno studio statunitense che ha utilizzato i criteri diagnostici definiti dal DSM-III (Diagnostic and Statistical Manual of Mental Disorders -III ed.), ha stimato che un soggetto su 20 sviluppa un disturbo d'ansia generalizzato nel corso della vita [5]. Un recente studio di coorte, che ha seguito soggetti affetti da disturbi depressivi e disturbi d'ansia per oltre 2 anni, ha riscontrato che la diagnosi di disturbo d'ansia generalizzato era confermata nel 49% di coloro per i quali era stata posta inizialmente [6].Alcune recenti revisioni della letteratura hanno rilevato che il disturbo d'ansia generalizzato ha un'incidenza circa doppia nelle donne [7] e minore nei soggetti anziani [8].Il disturbo di panico esordisce spes...