With a large amount of people suffering from anxiety disorders, it forms the most common group of mental disorders. A research topic of interest of both Amsterdam Neuroscience and Amsterdam Public Health. Brenda Penninx (Professor of psychiatric epidemiology at the department of Psychiatry of Amsterdam UMC), wrote with international colleagues a seminar paper on anxiety disorders that was recently published in The Lancet. This article summarizes the scientific knowledge on the diagnosis, epidemiology, pathophysiology, and prevention with emphasis on evidence from the last five years.

Brenda Penninx: “Anxiety Disorders have a huge negative impact on public health, there still is quite substantial undertreatment. This is unfortunate as we do have effective psychotherapy and medication interventions available. In this paper we describe the evidence for these treatments, and sketch important areas for future research.”

Anxiety disorders most often start before or in early adulthood. Core features include excessive fear and anxiety or avoidance of perceived threats that are persistent and impairing. It involves dysfunction in brain circuits that respond to danger. Risk for anxiety disorders is influenced by genetic factors, environmental factors, and their epigenetic relations. Anxiety disorders are often comorbid with one another and with other mental disorders, especially depression, as well as with somatic disorders. Such comorbidity generally signifies more severe symptoms, greater clinical burden, and greater treatment difficulty.

Reducing the large burden of disease from anxiety disorders in individuals and worldwide can be best achieved by timely, accurate disease detection and adequate treatment administration, scaling up of treatments when needed. Evidence-based psychotherapy (particularly cognitive behavioral therapy) and psychoactive medications (particularly serotonergic compounds) are both effective, facilitating patients' choices in therapeutic decisions. Although promising, no enduring preventive measures are available, and, along with frequent therapy resistance, clinical needs remain unaddressed. Ongoing research efforts tackle these problems, and future efforts should seek individualized, more effective approaches for treatment with precision medicine.

Read full article in 'the Lancet'.