Anxiety disorders
Open accessAbstract
Anxiety disorders form the most common group of mental disorders and generally start before or in early adulthood. Core features include excessive fear and anxiety or avoidance of perceived threats that are persistent and impairing. Anxiety disorders involve dysfunction in brain circuits that respond to danger. Risk for anxiety disorders is influenced by genetic factors, environmental factors, and their epigenetic relations. Anxiety disorders are often comorbid with one another and with other mental disorders, especially depression, as well as with somatic disorders. Such comorbidity generally signifies more severe symptoms, greater clinical burden, and greater treatment difficulty. Reducing the large burden of disease from anxiety disorders in individuals and worldwide can be best achieved by timely, accurate disease detection and adequate treatment administration, scaling up of treatments when needed. Evidence-based psychotherapy (particularly cognitive behavioural therapy) and psychoactive medications (particularly serotonergic compounds) are both effective, facilitating patients' choices in therapeutic decisions. Although promising, no enduring preventive measures are available, and, along with frequent therapy resistance, clinical needs remain unaddressed. Ongoing research efforts tackle these problems, and future efforts should seek individualised, more effective approaches for treatment with precision medicine.
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Individuals with anxiety disorders often rely on maladaptive coping behaviors such as anxious avoidance, substance use, and maladaptive emotion regulation strategies.
“In an effort to cope with the discomfort of intense anxiety and panic, individuals with anxiety disorders often rely on maladaptive coping behaviors, such as anxious avoidance, substance use, and maladaptive emotion regulation strategies [11].”
From Correlates of Quality of Life in Anxiety Disorders: Review of Recent Research (2021) · cites this paper as [11]
The Clinical presentation and Clinical management > Psychotherapy passages (page unavailable) describe avoidance as a feature of anxiety disorders and a behaviour that can perpetuate anxiety. The Comorbidity and differential diagnosis passage notes co-occurring substance dependence, but does not say people use substances to cope with anxiety; the retrieved passages also do not establish maladaptive emotion-regulation strategies as a common coping behaviour. (LLM, conf=0.85)
Experimental — accuracy not yet measuredComorbidity in anxiety disorders is associated with more severe symptoms, a more chronic course, and greater functional impairment.
“Comorbidity in anxiety disorders is associated with more severe symptoms, a more chronic course, and greater functional impairment [11, 26, 28].”
From Correlates of Quality of Life in Anxiety Disorders: Review of Recent Research (2021) · cites this paper as [11]
The Comorbidity and differential diagnosis section says anxiety–depression comorbidity signifies higher severity, burden, and chronicity than either disorder alone. The Abstract likewise links comorbidity to more severe symptoms and greater clinical burden. Neither passage specifically establishes greater functional impairment, so that part of the claim is more specific than the evidence. (LLM, conf=0.83)
Experimental — accuracy not yet measuredAnxiety disorders have a high ratio of 1-year to lifetime prevalence, suggesting a chronic recurrent course.
“Epidemiological research indicates that anxiety disorders have a high ratio of 1-year lifetime prevalence, suggesting a chronic recurrent course [11].”
From Correlates of Quality of Life in Anxiety Disorders: Review of Recent Research (2021) · cites this paper as [11]
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The Prevalence of Psychiatric Disorders in General Hospital Inpatients: A Systematic Umbrella Review
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Dissecting the shared genetic landscape of anxiety, depression, and schizophrenia
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Propiedades psicométricas del GAD-7, GAD-2 y GAD-Mini en universitarios peruanos
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Depression and Quality of Life in Patients with Gliomas: A Narrative Review
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Association between anxiety and metabolic syndrome: An updated systematic review and meta-analysis
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Quantitative Electroencephalography (QEEG) as an Innovative Diagnostic Tool in Mental Disorders
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Fear of Cancer Recurrence in Adult Survivors of Childhood Cancer
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Epigenetics of Fear, Anxiety and Stress – Focus on Histone Modifications
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Medicinal Cannabis and Central Nervous System Disorders
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Trace Minerals and Anxiety: A Review of Zinc, Copper, Iron, and Selenium
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Anxiety disorders: Treatments, models, and circuitry mechanisms
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Beyond Seizure Control: Treating Comorbidities in Epilepsy via Targeting of the P2X7 Receptor
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Anxiety Disorder and Cardiovascular Disease: A Two-Sample Mendelian Randomization Study
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Developmental Epidemiology of Pediatric Anxiety Disorders
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- Authors
- Penninx, B. W., Pine, D. S., Holmes, E. A., & Reif, A.
- Affiliations
- GGZ inGeest (NL)
- National Institute of Mental Health (US)
- Uppsala University (SE)
- Goethe University Frankfurt (DE)
- Corresponding author
- Penninx, Brenda WJH
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 397
- Issue
- 10277
- Pages
- 914-927
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC9248771
- OpenAlex
- W4211110355
- Cited by
- 740
- References
- 137
- Citations by year
- 2026: 162 · 2025: 192 · 2024: 196 · 2023: 114 · 2022: 63 · 2021: 13
- FWCI
- 15.76
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-03-06)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- PubMed Central (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (ZIAMH002781)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- anxiety disorders, avoidance, brain circuits, genetic risk factors, environmental risk factors, epigenetics, comorbidities, depression, somatic diseases, disease burden, early detection, cognitive behavioral therapy, serotonergic medications, treatment resistance, prevention, precision medicine
- MeSH terms
- Anxiety Disorders, Humans, Psychotherapy, Psychotropic Drugs, Comorbidity
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