There is ample evidence concerning the burden of anxiety disorders. We clinicians know the personal distress of those suffering with panic attacks, severe phobias or obsessive–compulsive disorder, not to mention people living with stigmas of traumatic experiences. In addition to psychic pain, pathological anxiety severely affects the patient’s existence, causing a state of dependence which most often starts in early adulthood and has long-standing consequences, disrupting both family life and professional career.
Anxiety disorders, in particular panic attacks, go along with various autonomic disturbances that trigger physical complaints and motivate medical procedures. Therefore, when not properly recognized, anxiety syndromes often induce useless and sometimes expensive complementary investigations, adding unnecessary strain for the patient and costs for the health care system. Finally, there is accumulating evidence that an anxiety disorder, when left untreated, may worsen the prognosis of a coexisting somatic condition. This has been clearly demonstrated in case of cardiac diseases. It certainly holds true in many other instances.
Overall, anxiety disorders represent an impressive burden of individual suffering, social impairment and economic costs. However, all too often the patient’s symptoms are not properly interpreted. It has been estimated that in primary care, less than half of the subjects presenting with an anxiety disorder are recognized as having a clinically relevant condition. Only a subset of them will be diagnosed as suffering with an anxiety disorder. And again, only a small part of those with a correct diagnosis of
anxiety will be fully informed and offered a state-of-the-art treatment.
As decision making for treatment of any disorder becomes more complex, a sound insight of the
underlying mechanisms will be essential. Hence, the good therapist should have an appropriate knowledge of basic psychology and neurosciences.
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