The Zurich Study. V. Anxiety and phobia in young adults.

From data collected within the frame of a longitudinal epidemiologic study of a representative sample population of young adults (the Zurich Study), anxiety disorders--anxiety and phobic states--were analyzed. The current prevalence rate was found to be 2.9% for anxiety states and 4.3% for phobic states, totaling 7.2%. Because of their anxiety disorders, one-fifth of the cases had undergone treatment during the preceding 12 months. Substantial difficulties arose, from the point of view of classification. The currently used categories, such as anxiety states, panic attacks, agoraphobia, simple phobia, social phobia, have more in common than differing symptoms. On a syndromal level, numerous overlapping configurations resulted which can only be artificially forced into the aforementioned diagnostic classes of anxiety disorders. On the symptom level, merely a few operationalized items defined these categories. In this way, most of a broad identical 'nonspecific' symptomatology was not taken into account. This was exemplified by a comparison of anxiety states and agoraphobia. In fact, these two groups did not differ significantly in many symptoms or in SCL-90 profiles, but did show a highly significant difference from control samples. Both groups suffered to the same great degree from depressive, cardiovascular, and gastrointestinal symptoms. We doubt whether any forced categorical diagnostic differentiation of anxiety and phobic states is at all reasonable.