University of Virginia, Charlottesville, VA.
Mount Sinai Beth Israel Hospital, New York, NY.
Am Fam Physician. 2022 Aug;106(2):157-164.
Generalized anxiety disorder (GAD) and panic disorder (PD) are common mental health conditions in adults that are often seen in primary care. Although there is insufficient evidence to support universal screening for PD and GAD, evaluation should be considered in patients who express recurrent, pervasive worry or present with somatic symptoms not attributed to underlying medical conditions. The GAD-7 and Patient Health Questionnaire for PD are validated screening tools that can aid in diagnosis and assessment. Anxiety disorders often present with substance use disorders, which should be treated concurrently. Effective therapies for PD and GAD include cognitive behavior therapy and anti-depressants, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Benzodiazepines are not recommended for first-line therapy or long-term use because of adverse reactions, risk of dependence, and higher mortality. No consistent evidence currently supports a specific prevention strategy for PD or GAD, but exercise may be beneficial.
广泛性焦虑障碍（GAD）和惊恐障碍（PD）是常见的成人心理健康疾病，常在初级保健中见到。虽然没有足够的证据支持对 PD 和 GAD 进行普遍筛查，但对于表达反复、普遍担忧的患者，或出现不能归因于潜在医学状况的躯体症状的患者，应考虑进行评估。GAD-7 和惊恐障碍患者健康问卷是经过验证的筛查工具，可辅助诊断和评估。焦虑障碍常与物质使用障碍同时出现，应同时进行治疗。PD 和 GAD 的有效治疗方法包括认知行为疗法和抗抑郁药，包括选择性 5-羟色胺再摄取抑制剂和 5-羟色胺去甲肾上腺素再摄取抑制剂。由于不良反应、依赖风险和更高的死亡率，苯二氮䓬类药物不推荐作为一线治疗或长期使用。目前尚无一致证据支持 PD 或 GAD 的特定预防策略，但运动可能有益。
