The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management
The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management
The clinical construct of “anxiety neurosis” was broad and poorly defined, so that the delineation of specific anxiety disorders in the DSM-III was an important advance. However, anxiety and related disorders are not only frequently comorbid, but each is also quite heterogeneous; thus diagnostic manuals provide only a first step towards formulating a management plan, and the development of additional decision support tools for the treatment of anxiety conditions is needed. This paper aims to describe systematically important domains that are relevant to the personalization of management of anxiety and related disorders in adults. For each domain, we summarize the available research evidence and review the relevant assessment instruments, paying special attention to their suitability for use in routine clinical practice. We emphasize areas where the available evidence allows the clinician to personalize the management of anxiety conditions, and we point out key unmet needs. Overall, the evidence suggests that we are becoming able to move from simply recommending that anxiety and related disorders be treated with selective serotonin reuptake inhibitors, cognitive-behavioral therapy, or their combination, to a more complex approach which emphasizes that the clinician has a broadening array of management modalities available, and that the treatment of anxiety and related disorders can already be personalized in a number of important respects.
Anxiety, anxiety and related disorders, clinical subtypes, dysfunctional cognitive schemas, early environmental exposures, family history, functioning, neurocognition, obsessive-compulsive disorder, personality traits, personalization of treatment, physical comorbidities, post-traumatic stress disorder, protective factors, psychiatric antecedents, psychiatric comorbidities, quality of life, recent environmental exposures, severity, symptom profile
336-356
Stein, Dan J.
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Craske, Michelle G.
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Rothbaum, Barbara O.
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Chamberlain, Samuel R.
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Fineberg, Naomi A.
157dcac1-9fb2-4197-81f3-0167e1224f05
Choi, Karmel W.
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de Jonge, Peter
8dc1a20d-ec25-4d72-ac46-37cce0614cb5
Baldwin, David S.
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Maj, Mario
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9 September 2021
Stein, Dan J.
81ae9dac-89c4-446a-bda0-73d12749be45
Craske, Michelle G.
73ebe43a-d149-4bd1-a1ce-8cc69e8c3929
Rothbaum, Barbara O.
d34b0e10-6c38-4199-8b20-62f792f6d020
Chamberlain, Samuel R.
8a0e09e6-f51f-4039-9287-88debe8d8b6f
Fineberg, Naomi A.
157dcac1-9fb2-4197-81f3-0167e1224f05
Choi, Karmel W.
50b5225d-9228-4b63-9a40-9f0010b2110c
de Jonge, Peter
8dc1a20d-ec25-4d72-ac46-37cce0614cb5
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Maj, Mario
7e17e11e-cf26-485b-8b0d-244099d4630c
Stein, Dan J., Craske, Michelle G., Rothbaum, Barbara O., Chamberlain, Samuel R., Fineberg, Naomi A., Choi, Karmel W., de Jonge, Peter, Baldwin, David S. and Maj, Mario
(2021)
The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management.
World Psychiatry, 20 (3), .
(doi:10.1002/wps.20919).
Abstract
The clinical construct of “anxiety neurosis” was broad and poorly defined, so that the delineation of specific anxiety disorders in the DSM-III was an important advance. However, anxiety and related disorders are not only frequently comorbid, but each is also quite heterogeneous; thus diagnostic manuals provide only a first step towards formulating a management plan, and the development of additional decision support tools for the treatment of anxiety conditions is needed. This paper aims to describe systematically important domains that are relevant to the personalization of management of anxiety and related disorders in adults. For each domain, we summarize the available research evidence and review the relevant assessment instruments, paying special attention to their suitability for use in routine clinical practice. We emphasize areas where the available evidence allows the clinician to personalize the management of anxiety conditions, and we point out key unmet needs. Overall, the evidence suggests that we are becoming able to move from simply recommending that anxiety and related disorders be treated with selective serotonin reuptake inhibitors, cognitive-behavioral therapy, or their combination, to a more complex approach which emphasizes that the clinician has a broadening array of management modalities available, and that the treatment of anxiety and related disorders can already be personalized in a number of important respects.
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More information
e-pub ahead of print date: 9 September 2021
Published date: 9 September 2021
Keywords:
Anxiety, anxiety and related disorders, clinical subtypes, dysfunctional cognitive schemas, early environmental exposures, family history, functioning, neurocognition, obsessive-compulsive disorder, personality traits, personalization of treatment, physical comorbidities, post-traumatic stress disorder, protective factors, psychiatric antecedents, psychiatric comorbidities, quality of life, recent environmental exposures, severity, symptom profile
Identifiers
Local EPrints ID: 453811
URI: http://eprints.soton.ac.uk/id/eprint/453811
ISSN: 1723-8617
PURE UUID: 308a0995-73b4-48a2-be11-92aa8b40225a
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Date deposited: 24 Jan 2022 17:53
Last modified: 17 Mar 2024 04:03
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Contributors
Author:
Dan J. Stein
Author:
Michelle G. Craske
Author:
Barbara O. Rothbaum
Author:
Samuel R. Chamberlain
Author:
Naomi A. Fineberg
Author:
Karmel W. Choi
Author:
Peter de Jonge
Author:
Mario Maj
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