Department of Psychiatry and Psychotherapy, Campus Charité Mitte (CCM), Charité-Universitätsmedizin Berlin; Institute of General Practice, Faculty of Medicine, Ludwig-Maximilians-Universität München; Department of Psychiatry and Psychotherapy, University Hospital of Freiburg.
Dtsch Arztebl Int. 2018 Sep 14;155(37):611-620. doi: 10.3238/arztebl.2018.0611.
Anxiety disorders are the most common type of mental illness in Europe, with a 12-month prevalence of 14% among persons aged 14 to 65. Their onset is usually in adolescence or early adulthood. The affected patients often develop further mental or somatic illnesses (sequential comorbidity).
This review is based on pertinent publications retrieved by a selective search in PubMed.
The group of anxiety disorders includes generalized anxiety disorder (GAD), phobic disorders, panic disorders, and two disorders that are often restricted to childhood-separation anxiety and selective mutism. A comprehensive differential diag- nostic evaluation is essential, because anxiety can be a principal manifestation of other types of mental or somatic illness as well. Psychotherapy and treatment with psychoactive drugs are the therapeutic strategies of first choice. Of all types of psycho- therapy, cognitive behavioral therapy has the best documented efficacy. Modern antidepressants are the drugs of first choice for the treatment of panic disorders, agoraphobia, social phobia, and GAS; pregabalin is a further drug of first choice for GAS.
In general, anxiety disorders can now be effectively treated. Patients should be informed of the therapeutic options and should be involved in treatment planning. Current research efforts are centered on individualized and therefore, it is hoped, even more effective treatment approaches than are available at present.
焦虑障碍是欧洲最常见的精神疾病，14-65 岁人群中 12 个月的患病率为 14%。其发病通常在青少年或成年早期。受影响的患者经常会发展出其他精神或躯体疾病（序贯共病）。
本综述基于在 PubMed 中进行选择性搜索获得的相关出版物。
焦虑障碍包括广泛性焦虑障碍（GAD）、恐惧症、恐慌症以及两种通常局限于儿童的疾病——分离焦虑和选择性缄默症。全面的鉴别诊断评估至关重要，因为焦虑也可能是其他类型的精神或躯体疾病的主要表现。心理治疗和精神活性药物治疗是首选的治疗策略。在所有类型的心理治疗中，认知行为疗法的疗效记录最为完备。新型抗抑郁药是治疗恐慌症、广场恐惧症、社交恐惧症和广泛性焦虑症的首选药物；普瑞巴林是广泛性焦虑症的另一种首选药物。
一般来说，焦虑障碍现在可以得到有效治疗。应向患者告知治疗选择，并让其参与治疗计划。目前的研究重点是个体化治疗方法，因此有望采用比目前更为有效的治疗方法。
