Anxiety disorders examples

The anxiety disorders are a case in point. They comprise a range of conditions contiguous with the affective disorders and the stress responses (Table 4.1). Much overlap and comorbidity exist. Furthermore, definitions and diagnostic criteria have changed substantially over the years. For example, generalized anxiety disorder is a rare condition in its pure form, but a common condition if comorbid phobic and depressive disorders are accepted. 

Anxiety disorders represent a diverse class of illnesses, with varied ages of onset. For example, according to the NCS-R epidemiologic study,3 PD and GAD had a median age of onset of 24 and 31 years, respectively, whereas specific phobia and social anxiety disorder (SAD) tend to develop much earlier (median age of onset 7 and 13 years, respectively). Although GAD and PD may not manifest fully until adulthood, as many as half of adult anxiety patients report subthreshold symptoms during childhood.6... 

Patients tend to believe that medications from nature are non-toxic, non-addicted, and non-invasive. Therefore complementary medicines are usually used in common, less severe, and chronic mental disorders such as sleep disorders, neurasthenia, and anxiety disorders. It is also applied in incurable conditions, for example dementias, autism, and schizophrenia, when doctors and families have tried desperately all means and finally turned to complementary medicine as the last hope. 

Others have suggested that in the rush to publish subsequent revisions to the DSM—III (American Psychiatric Association, 1980), there has been insufficient time between revisions to evaluate the adequacy of the extant diagnoses for a given version (Zimmerman, 1988). Evaluation of the appendix of the DSM-III-R (American Psychiatric Association, 1987) supports this contention, as it appears that only a minority of the changes from the DSM-III to the DSM-III-R were clearly based on newly acquired or accumulated research. The same criticism can be leveled at the DSM—IV (American Psychiatric Association, 1994), which closely followed the DSM-III-R for example, only 3 of the 12 changes to the DSM-IV anxiety disorders section appear to be linked with a literature review or evidence acquired from field trials (pp. 782-783). 

As you might expect, the diagnostic criteria for panic disorder requires the presence of recurrent panic attacks, but panic attacks alone are not sufficient for the diagnosis of panic disorder. Those with other anxiety disorders, for example, can experience panic attacks when confronted by the situation or object that they fear. 

These examples underline that in the search for animal models of anxiety disorders it is not sufficient to screen for anxiety-related behavioral characteristics. On the contrary, it is of fundamental importance to phenotype extensively and carefully each potential animal model, even the well-established inbred mouse strains. 

The family study approach, particularly when employed with systematic community-based samples, is one of the most powerful strategies to minimize heterogeneity, since etiologic factors for the development of a particular disorder can be assumed to be relatively homotypic within famihes. There is a dearth of studies that have employed within-family designs to examine either phenotypic expression or some of the putative biologic factors underlying the major anxiety disorders. For example,both Perna et al. (1996,1995) and Coryell... 

Many patients with anxiety disorders experience an increased susceptibihty to psychosocial stress. Behavioral sensitization may account for these cHnical phenomena, hi the laboratory model of sensitization, single or repeated exposure to physical stimuU or pharmacological agents sensitizes an animal to subsequent stressors (reviewed in Charney et al. 1993). For example, in animals with a history of prior stress, there is a potentiated release of NE in the hippocampus with subsequent exposure to stressors (Nisenbaum et al. 1991). Similar findings were observed in medial prefrontal cortex (Finlay and Abercrombie 1991). The hypothesis that sensitization is underlying neural mechanism contributing to the course of anxiety disorders is supported by clinical studies demonstrating that repeated exposure to traumatic stress is an important risk factor for the development of anxiety disorders, particularly PTSD (Table 1). 

The diagnosis generalized anxiety disorder, not otherwise specified refers to a free-floating state of anxiety that is not firmly bounded. For example, a person with a diagnosis of generalized anxiety would be differentiated from someone who suffers specifically from panic disorders or from another particular phobia. 

Other examples of pyrimidine-based pharmaceuticals include busipirone 1130, used to treat anxiety disorders, piribedil 1131 used for Parkinson s disease, epirizole 1132, a nonsteroidal antinflammatory (NSAID), pyrimethamine 1133, an antimalarial, minoxidil 1134, which is used for treating alopecia (male baldness), primidone 1135, which is used as an antiepileptic agent, and pyrantel pamoate 1136, which is used as an antiparasitic. 

Another way that hypnosis is helpful in anxiety disorders is that it is able to produce intense concentration on a particular subject distinct from the source of anxiety or fear. For example, a person with a fear of flying may be told to imagine that he is simply going into a room to get a restful sleep when he is boarding a plane. This concentration on the nonthreatening scenario allows the person to get on a plane without experiencing feelings of anxiety. 

As other indications are sought for the SSRls, it is clear that their action extends beyond depression, dysthymia, and the anxiety disorders, and the broad spectrum of therapeutic action of these antidepressants becomes apparent. For example, based on the evidence from placebo-controlled studies [A. Wood 1993], fluoxetine has been licensed in Europe for the treatment of bulimia, and several SSRls are reported to be effective in the treatment of premenstrual syndrome. 

---