Byrne Gerard J
Academy of Psychiatry, School of Medicine, University of Queensland.
Mental Health Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Curr Opin Psychiatry. 2023 Mar 1;36(2):134-139. doi: 10.1097/YCO.0000000000000840. Epub 2022 Dec 6.
To provide an overview of recently published work on anxiety, focusing on generalized anxiety disorder (GAD) and its treatment.
Self-reported anxiety symptoms were highly prevalent during the COVID-19 global pandemic in both the general population and in selected groups. There remains divided opinion about whether internet-based cognitive behavioural therapy (CBT) is noninferior to face-to-face CBT for GAD. A systematic review of drug treatment for GAD showed efficacy for selective serotonin reuptake inhibitors (SNRIs), agomelatine, and quetiapine. There may be a place for repetitive transcranial magnetic stimulation in the treatment of GAD. There was some evidence of efficacy for complementary therapies, including physical exercise, yoga, acupuncture, and Withania somnifera (ashwagandha). However, a systematic review of cannabidiol and tetrahydrocannabinol found insufficient evidence of efficacy in anxiety disorders.
Antidepressants and quetiapine show efficacy in the treatment of GAD. Internet-based psychological interventions have a place in the treatment of GAD when face-to-face treatment is inaccessible. There is increasing evidence for the use of physical exercise in the management of GAD. Some other complementary therapies, including cannabinoids, require further, methodologically sound, research.
概述近期发表的关于焦虑症的研究工作，重点关注广泛性焦虑障碍（GAD）及其治疗。
在新冠疫情全球大流行期间，普通人群和特定群体中自我报告的焦虑症状非常普遍。对于基于互联网的认知行为疗法（CBT）治疗GAD是否不劣于面对面CBT，仍存在分歧。一项关于GAD药物治疗的系统评价显示，选择性5-羟色胺再摄取抑制剂（SNRIs）、阿戈美拉汀和喹硫平有效。重复经颅磁刺激在GAD治疗中可能有一席之地。有一些证据表明补充疗法有效，包括体育锻炼、瑜伽、针灸和南非醉茄（印度人参）。然而，一项关于大麻二酚和四氢大麻酚的系统评价发现，在焦虑症治疗中疗效证据不足。
抗抑郁药和喹硫平在GAD治疗中显示出疗效。当无法进行面对面治疗时，基于互联网的心理干预在GAD治疗中占有一席之地。越来越多的证据表明体育锻炼可用于管理GAD。其他一些补充疗法，包括大麻素，需要进一步开展方法严谨的研究。
