Clinical Manual of Anxiety Disorders

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Anxiety disorders are among the most prevalent, persistent, disabling, and costly psychiatric disorders, yet they are often underdiagnosed and undertreated. Fortunately, there have been major advances in understanding and treating these conditions in recent years; this is one of the most exciting areas in modern medicine.

This clinical manual has earned its place in the literature as one of just a few volumes that covers all of the major anxiety disorders and presents integrated contributions from both psychopharmacologists and psychotherapists—all in one compact work written for busy clinicians.

Though concepts of anxiety have long enjoyed a central position in philosophical and psychoanalytic theories, empirical research on anxiety disorders has a relatively short history. Here, 16 experts discuss advances in diagnosis, assessment (including relevant rating scales), pharmacotherapy, and psychotherapy.

This volume begins by reviewing recent important diagnostic, epidemiological, neurobiological, and treatment findings—all of which have significant implications for clinicians. Subsequent chapters cover

  • Panic disorder and agoraphobia—Laboratory studies of fear have significantly advanced our understanding of the neurocircuitry and neurochemistry of panic. Furthermore, panic disorder is now readily treated with both medications and psychotherapy.

  • Specific phobia—Viewed for many years as mild and even trivial, this common disorder is now recognized for its very real associated distress and impairment. Exposure therapy is the treatment mainstay, though pharmacotherapy should be considered particularly when there is comorbidity.

  • Social phobia (or social anxiety disorder)—In the past few years, the first FDA-approved medications for this disorder have been made available. Cognitive-behavioral therapy is also effective for the treatment of this underdiagnosed and undertreated condition.

  • Obsessive-compulsive disorder (OCD)—OCD was the first disorder where it was shown that both specific medications and cognitive-behavioral techniques resulted in normalization of activity in particular brain structures. It is now possible to provide patients with integrated treatment approaches.

  • Posttraumatic stress disorder (PTSD)—Once viewed as a normal reaction to trauma, PTSD is increasingly understood as a pathological response, characterized by specific psychobiological dysfunctions. Again, there have been exciting advances in the treatment of this disorder, with the release of the first FDA-approved agents for PTSD.

  • Generalized anxiety disorder (GAD)—For a number of years GAD was thought of as a residual disorder occasionally seen in combination with more primary conditions. Nowadays, we know that GAD is an independent condition that is prevalent, persistent, and disabling.

Busy residents and psychiatrists in active clinical practice, psychologists, primary care practitioners, and other mental health professionals will find this clinical manual—with its integrated approach of both pharmacotherapy and psychotherapy—a valuable tool in their everyday practices.

Author(s): Dan J. Stein
Edition: 1
Publisher: American Psychiatric Publishing, Inc.
Year: 2004

Language: English
Commentary: 22492
Pages: 201

Contents......Page 6
Contributors......Page 12
Diagnosis......Page 14
Epidemiology......Page 16
Pathogenesis......Page 18
Management......Page 19
References......Page 23
Symptoms......Page 26
Associated Features......Page 29
Epidemiology......Page 31
Differential Diagnosis......Page 32
Pathogenesis......Page 34
Neurochemistry......Page 35
Neuroanatomy......Page 37
Antidepressants......Page 38
Benzodiazepines......Page 40
Other Agents......Page 41
Maintenance Pharmacotherapy......Page 42
Treatment-Refractory Panic Disorder......Page 44
Cognitive-Behavioral Therapy......Page 45
Combined Treatments......Page 47
Conclusion......Page 48
References......Page 49
Symptoms......Page 56
Associated Features......Page 58
Epidemiology......Page 59
Assessment......Page 60
Basic Physiology and Anatomy of Fear......Page 61
Application to Specific Phobia......Page 62
Etiological Models......Page 63
The Role of Disgust......Page 65
Psychotherapy......Page 66
Behavioral Approaches......Page 67
Efficacy of Behavioral and Cognitive Treatments......Page 69
References......Page 70
Symptoms......Page 76
Associated Features......Page 78
Differential Diagnosis......Page 79
Assessment Measures......Page 80
Biological......Page 83
Psychosocial......Page 84
Selective Serotonin Reuptake Inhibitors......Page 86
Benzodiazepines......Page 87
β-Adrenergic Blockers......Page 88
Other Medications......Page 89
Exposure......Page 90
Cognitive Restructuring......Page 91
Social Skills Training......Page 92
References......Page 93
Symptoms......Page 100
Associated Features......Page 102
Assessment......Page 104
Pathogenesis......Page 106
Genetic Epidemiology......Page 107
Neurochemistry......Page 108
Management......Page 109
Partial Response and Treatment Resistance......Page 110
Psychotherapy......Page 116
Behavioral Model of Obsessive-Compulsive Disorder......Page 119
Cognitive Model of Obsessive-Compulsive Disorder......Page 123
Conclusion......Page 127
References......Page 128
Symptoms......Page 132
Associated Features......Page 135
Epidemiology......Page 136
Assessment......Page 137
Pathogenesis......Page 138
Posttraumatic Stress Disorder......Page 141
Early Psychodynamic History......Page 146
Cognitive-Behavioral Therapy for Posttraumatic Stress Disorder......Page 147
Conclusion......Page 152
References......Page 154
Symptoms......Page 160
Epidemiology......Page 162
Differential Diagnosis......Page 163
Assessment Measures......Page 165
Worry......Page 166
Neurobiology......Page 167
Antidepressants......Page 168
Benzodiazepines......Page 171
Buspirone......Page 172
Hydroxyzine......Page 174
Psychotherapy......Page 175
Psychoeducation......Page 176
Relaxation......Page 177
Other Techniques......Page 178
References......Page 179
Appendix: Internet Resources......Page 186
A......Page 188
C......Page 190
D......Page 191
E......Page 192
G......Page 193
L......Page 194
N......Page 195
P......Page 196
S......Page 198
Y......Page 200