Ballenger J C, Davidson J R, Lecrubier Y, Nutt D J, Borkovec T D, Rickels K, Stein D J, Wittchen H U
Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, SC 29425-0742, USA.
J Clin Psychiatry. 2001;62 Suppl 11:53-8.
To provide primary care clinicians with a better understanding of management issues in generalized anxiety disorder (GAD) and guide clinical practice with recommendations on the appropriate treatment strategy.
The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R.T. Davidson, Yves Lecrubier, and David J. Nutt. Four additional faculty members invited by the chair were Karl Rickels, Hans-Ulrich Wittchen, Dan J. Stein, and Thomas D. Borkovec.
The consensus statement is based on the 6 review articles that are published in this supplement and the scientific literature relevant to the issues reviewed in these articles.
Group meetings were held over a 2-day period. On day 1, the group discussed the review articles and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees.
GAD is the most common anxiety disorder in primary care and is highly debilitating. Furthermore, it is frequently comorbid with depression and other anxiety disorders, which exacerbates functional impairment. Antidepressants (serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and nonsedating tricyclic antidepressants) are generally the most appropriate first-line pharmacotherapy for GAD, since they are also effective against comorbid psychiatric disorders and are suitable for long-term use. Cognitive-behavioral therapy is the preferred form of psychotherapy for GAD, although when GAD is comorbid with depression, pharmacotherapy is increasingly indicated.
使基层医疗临床医生更好地理解广泛性焦虑障碍（GAD）的管理问题，并通过关于适当治疗策略的建议来指导临床实践。
抑郁与焦虑国际共识小组的4名成员分别是詹姆斯·C·巴伦杰（主席）、乔纳森·R·T·戴维森、伊夫·勒克鲁比耶以及大卫·J·纳特。主席邀请的另外4名教员分别是卡尔·里克斯、汉斯 - 乌尔里希·维特琴、丹·J·斯坦以及托马斯·D·博尔科维奇。
该共识声明基于本增刊中发表的6篇综述文章以及与这些文章中所探讨问题相关的科学文献。
小组会议为期两天。第一天，小组讨论了综述文章，主席确定了需进一步辩论的关键问题。第二天，小组就这些问题进行讨论以达成共识观点。小组会议结束后，共识声明由主席起草并经所有参会者批准。
GAD是基层医疗中最常见的焦虑障碍，且极具致残性。此外，它常与抑郁症及其他焦虑障碍共病，这会加剧功能损害。抗抑郁药（5-羟色胺再摄取抑制剂、5-羟色胺 - 去甲肾上腺素再摄取抑制剂以及非镇静性三环类抗抑郁药）通常是治疗GAD最适宜的一线药物疗法，因为它们对共病的精神障碍也有效且适合长期使用。认知行为疗法是治疗GAD首选的心理治疗形式，不过当GAD与抑郁症共病时，药物治疗的指征越来越明显。
