Spectrum of Anxiety Disorders: Diagnosis and Pharmacologic Treatment

Abstract

Nearly 30% of women experience an anxiety disorder at some time during their lives, and there is increasing evidence that anxiety disorders are associated with adverse pregnancy outcomes. Despite increased media coverage regarding anxiety disorders, women are reluctant to discuss signs and symptoms of anxiety with family or health care providers. Additionally, despite ongoing research and improved educational curricula, primary care and women's health care providers find diagnosis and treatment of mental health disorders challenging. This article reviews the diagnostic features and pharmacologic treatment options for the most common anxiety disorders including generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, and posttraumatic stress disorder. The impact of anxiety disorders on pregnancy and guidelines for management are presented.

Sex differences in anxiety and emotional behavior

“…According to the current Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR), anxiety disorders are categorized into generalized anxiety disorder (GAD), panic disorder with or without agoraphobia, agoraphobia without history of panic disorder, posttraumatic stress disorder (PTSD), acute stress disorder, obsessive–compulsive disorder, social anxiety disorder (social phobia), anxiety secondary to a medical condition, substance-induced anxiety disorder, and stimulus-specific phobias [16, 189]. For this review, GAD, panic disorder, PTSD, and to a certain extent, acute stress disorder are of particular relevance because acute, repeated, or chronic stress exposures are common triggers for these psychiatric disorders [273, 286], because women may have an inherently increased stress vulnerability, and because key symptoms of these disorders have been successfully modeled in animals.…”

ELEVATED tph2 mRNA EXPRESSION IN A RAT MODEL OF CHRONIC ANXIETY

“…Anxiety disorders, including social anxiety disorder and panic disorder, are common emotional disorders, significantly impair overall quality of life, and affect about 19% of the male, and 30% of the female population at some point during life . The neural mechanisms underlying the manifestation of anxiety disorders are complex.…”

“…Anxiety disorders, including social anxiety disorder [1] and panic disorder, [2] are common emotional disorders, significantly impair overall quality of life, and affect about 19% of the male, and 30% of the female population at some point during life. [3][4][5] The neural mechanisms underlying the manifestation of anxiety disorders are complex. However, two interconnected neural systems commonly dysregulated in patients with anxiety disorders are the extended amygdala [6,7] and midbrain serotonergic systems.…”

Comparative Efficacy of the Generalized Anxiety Disorder 7-Item Scale and the Edinburgh Postnatal Depression Scale as Screening Tools for Generalized Anxiety Disorder in Pregnancy and the Postpartum Period

“…GAD has a lifetime prevalence of 5.7%1 and if left untreated can become a chronic disorder with low rates of remission 2,3. Risk factors of GAD include family history, an increase in situational stressors and (or) stressful life events,4,5 and a history of physical or emotional trauma 3,6. Many people with GAD report heightened anxiety beginning in childhood,4 with clinically significant anxiety symptoms emerging during the late teens through to the late twenties 7…”