Focus 2:333-342 (2004)
© 2004 American Psychiatric Association
Diagnosis and Treatment of Anxiety
Alexander Bystritsky, M.D.
From the Neuropsychiatric Institute and Hospital of the University of California, Los Angeles.
Correspondence: Send reprint requests to Dr. Bystritsky, Director, Anxiety Disorders Program, Neuropsychiatric Institute and Hospital, David Geffen School of Medicine, 300 UCLA Medical Plaza, Suite 2335, Los Angeles, CA 90095; e-mail, abystritsky{at}mednet.ucla.edu.
Anxiety disorders are highly prevalent, disabling conditions. The diagnoses of anxiety disorders are continually undergoing revision. In clinical treatment and research, both dimensional and structural diagnoses can be used, depending on the situation. Recently, emphasis has been placed on neuroimaging and genetic research as they apply to specific treatment sites. Although this research generally has not yet produced new treatments or diagnostic procedures, it has provided a more comprehensive understanding of how genetic, biological, and stress factors interact to shape the symptoms of anxiety. Anxiety disorders can be treated effectively with cognitive-behavioral and psychopharmacological interventions. Because these interventions target different symptoms, combinations of the different strategies need to be further studied. Alternative treatment strategies are widely used and continue to develop, but thus far they have not shown efficacy comparable to mainstream treatments. Treatment algorithms for anxiety disorders should be developed that can be used easily in primary care settings, and such algorithms should emphasize the management of functional impairment in patients with anxiety disorders.
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