Anxiety and obsessional disorders

Abstract

Anxiety disorders are disabling conditions. In anxiety disorders, the person experiences severe, often persistent (or recurrent) anxiety that is excessive and/or inappropriate to the situation. They often co-exist with other psychiatric conditions (depression, substance abuse). In medical or surgical disorders, distinguishing ‘normal’ anxiety from an anxiety disorder requiring treatment can be very difficult. This chapter presents the key features of anxiety, the main anxiety disorder subtypes, and the varied reactions to stress and trauma. The focus is on using the person’s symptoms to both understand their presentation (making the diagnosis) and to engage them in treatment. The chapter opens by presenting elements of anxiety that are easily understood and are present in all anxiety disorders, proceeding to highlight clinical features, course, and treatment for each of the main anxiety and obsessional disorders. This chapter provides knowledge about: • Physical and psychological symptoms of anxiety. • Shared features of anxiety disorders. • Specific features, course, and treatment of each of the disorders, including phobias, panic disorder, hypochondriasis, obsessive–compulsive disorder, acute stress reaction, and post-traumatic stress disorder. Practical tips include: • Key items to consider in diagnosing anxiety disorders. • Disorders to exclude. • The components of the anxiety triad.