Index for
slide deck
Introduction
History, definitions, and diagnosis
The spectrum of anxiety from ‘normal’ anxiety to disorder
Fear and anxiety are experienced on a spectrum, stretching from basic ‘normal’ emotions to the categorical phenotypes of anxiety disorders.1 Whilst much progress has been made in studying anxiety, it has been proposed that the Research Domain Criteria (RDoC) – that attemp…
Diagnosis of anxiety disorders
Diagnosis of anxiety disorders
The history of classification of anxiety
Ancient Greek and Roman doctors identified anxiety as a pathology, and various techniques were developed to treat the disorder.1 In modern times, the various iterations of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have categorized anxiety disorders i…
Classification systems for anxiety
Different currently used classification systems exist for anxiety disorders, including versions of the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) as shown on the slide.1-3
References:
ICD-11 classification of anxiety
Changes were made in the 11th edition of the International Classification of Diseases relative to the previous edition, with anxiety- or fear-related disorders now constituting a separate group not including obsessive‒compulsive and stress-associated disorders. Separation…
ICD-11 changes to classification of anxiety (I)
The slide shows some key differences between the 10th and 11th editions of the International Classification of Diseases in the diagnosis of separation anxiety disorder and selective mutism, and some of the rationale for the change.1
References:
ICD-11 changes to classification of anxiety (II)
The slide shows some key differences between the 10th and 11th editions of the International Classification of Diseases in the diagnosis of agoraphobia, social phobia, specific phobia, panic disorder, and generalized anxiety disorder, and some of the rationale for the cha…
ICD-11 changes to classification of anxiety (III)
The slide shows some key differences between the 10th and 11th editions of the International Classification of Diseases in the diagnosis of mixed anxiety and depressive disorder, or mixed depressive and anxiety disorder, respectively, and some of the rationale for the cha…
Anxiety disorders – generalized anxiety disorder (GAD)
People with generalized anxiety disorder experience excessive anxiety and worry about events or activities in their lives, worry that is out of proportion with the likely outcome.2 This worry is difficult to control and interferes with the individuals functioning.2
Refere…
Anxiety disorders – panic disorder
People with panic disorder experience recurrent and unexpected panic attacks.2 The frequency and severity of these panic attacks varies greatly between individuals.2
References:
1.Penninx BW, Pine DS, Holmes EA, Reif A. Anxiety disorders. Lancet 2021; 397 (10277): 914–927…
Anxiety disorders – agoraphobia
People with agoraphobia experience fear or anxiety triggered by actual or anticipated exposure to leaving the home, being in crowds, closed or open spaces, or public transport, with the fear primarily concerning situations in which escape might be difficult or help is not…
Anxiety disorders – specific phobia
People with specific phobias experience fear or anxiety associated with a specific thing – a situation or an object (e.g., animals, heights, injections).2 The reaction is more severe than a normal transient fearful reaction that the stimulus might provoke, and is provoked…
Anxiety disorders – social anxiety disorder (SAD)
People with social anxiety disorder experience a fear or anxiety of social situations in which they might be scrutinised by others.2 They worry is that they will be viewed or judged negatively by others, and this worry is almost always provoked by social situations.2
Refe…
Anxiety disorders – separation anxiety disorder
People with separation anxiety disorder experience fear or anxiety about being separated from home or from attachment figures.2 This anxiety exceeds what would be expected for the individual‘s developmental stage.2
References:
Anxiety disorders – selective mutism
People with selective mutism do not initiate speech, and do not respond when spoken to in situations where this conversation is expected.2 Children with selective mutism may speak at home and to parents for instance, but not in front of more distant family members or fami…
The ‘panic attack specifier’
Separate from panic disorder, panic attacks can be experienced in the context any anxiety disorder, and can be included diagnostically using the specifier outlined on the slide.1
References:
1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental D…
Suggested staging of anxiety disorders
This study used data from a cohort study to create a nine-stage model of anxiety disorder progression, which was found to have construct and predictive validity.1 A valid staging model of anxiety disorders would be of value in the clinic, to predict the disease course in …
Culture-related diagnostic issues
Specific factors seen in different cultural groups can complicate or mask symptoms of anxiety, such as the ‘attacks of wind’ observed in some refugee groups, and a cultural concern of disapproving social gaze seen in some people from Japan.1-4 These culture-related diagno…
Related content
In the video, Professor Dr. Brenda Penninx highlights a significant increase in the prevalence of anxiety disorders, with a 50% rise over the last decade, affecting about 10% of the population.
In this video, Professor Dr. Dan Stein highlights the dynamic nature of anxiety disorders, emphasizing the need to re-conceptualize them from a course perspective.
In this video, Professor Dr. Milan Latas highlights the high prevalence of comorbidity in anxiety disorders, with 50% or more of patients having additional psychiatric conditions