Department of Psychology, University of California Los Angeles, 405 Hilgard Avenue, Los Angeles, California 90095, USA.
Department of Psychiatry, University of California San Diego, La Jolla, California, USA.
Nat Rev Dis Primers. 2017 May 4;3:17024. doi: 10.1038/nrdp.2017.24.
Anxiety disorders constitute the largest group of mental disorders in most western societies and are a leading cause of disability. The essential features of anxiety disorders are excessive and enduring fear, anxiety or avoidance of perceived threats, and can also include panic attacks. Although the neurobiology of individual anxiety disorders is largely unknown, some generalizations have been identified for most disorders, such as alterations in the limbic system, dysfunction of the hypothalamic-pituitary-adrenal axis and genetic factors. In addition, general risk factors for anxiety disorders include female sex and a family history of anxiety, although disorder-specific risk factors have also been identified. The diagnostic criteria for anxiety disorders varies for the individual disorders, but are generally similar across the two most common classification systems: the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the International Classification of Diseases, Tenth Edition (ICD-10). Despite their public health significance, the vast majority of anxiety disorders remain undetected and untreated by health care systems, even in economically advanced countries. If untreated, these disorders are usually chronic with waxing and waning symptoms. Impairments associated with anxiety disorders range from limitations in role functioning to severe disabilities, such as the patient being unable to leave their home.
焦虑障碍在大多数西方社会中构成了最大的精神障碍群体,也是导致残疾的主要原因。焦虑障碍的基本特征是过度和持久的恐惧、焦虑或对感知到的威胁的回避,也可能包括惊恐发作。尽管个别焦虑障碍的神经生物学在很大程度上尚不清楚,但已经确定了大多数障碍的一些概括,例如边缘系统的改变、下丘脑-垂体-肾上腺轴的功能障碍和遗传因素。此外,焦虑障碍的一般风险因素包括女性和焦虑的家族史,尽管也确定了特定于障碍的风险因素。焦虑障碍的诊断标准因个体障碍而异,但在两个最常见的分类系统:精神障碍诊断与统计手册,第五版(DSM-5)和国际疾病分类,第十版(ICD-10)中基本相似。尽管它们具有公共卫生意义,但即使在经济发达的国家,绝大多数焦虑障碍仍然未被医疗保健系统发现和治疗。如果未得到治疗,这些障碍通常是慢性的,症状时好时坏。与焦虑障碍相关的障碍范围从角色功能的限制到严重的残疾,例如患者无法离开他们的家。