Anxiety disorders

Anxiety disorders (in the past referred to as neuroses) are among very common mental illnesses characterized by the presence of an excessive, unpleasant and recurring feeling of anxiety. Unlike psychoses, there is no gross disturbance of the personality and disordered perception of reality.

Anxiety, like stress, is a normal human emotion. These are important defense and adaptation mechanisms that help us to concentrate and "do our best" in certain situations (an anatomy exam, giving bad news to a patient).

Anxiety is to some extent a normal reaction of the organism to stress, which has an adaptive function and mobilizes energy. However, it must not exceed the tolerable limit – i.e. last too long, occur frequently, be too intense and inadequate. We talk about anxiety disorders when these defense mechanisms exceed their physiological framework, i.e. they become pathological. In this case, anxiety is subjectively perceived as a very unpleasant feeling, often accompanied by vegetative symptoms ( sweating , tachycardia , tachypnea ). According to behavioral theory, incorrectly learned stress coping mechanisms lead to anxiety disorders.

The term anxiety disorder includes the following conditions:


 * 1) phobic anxiety states;
 * 2) other anxiety disorders;
 * 3) obsessive-compulsive disorder ;
 * 4) severe stress response and adjustment disorders.

Epidemiology
Anxiety disorders affect approximately 25% of the population of the developed world. In the United States of America, about 40 million adults suffer from some form of anxiety disorder, which represents a serious medical-socio-economic problem. Anxiety, or anxiety disorder is sometimes referred to as the non-infectious epidemic of the 20th century.

Symptoms and Diagnosis
'Anxiety as a symptom is an unpleasantly perceived subjective feeling, associated with feelings of fear, apprehension and threat, which are not associated with a specific reason. We evaluate the severity of the disorder according to the degree of influence on the quality of life. Common symptoms of an anxiety disorder include:
 * anxiety, fear, worry;
 * depression;
 * phobia;
 * obsession;
 * lack of concentration, irritability, amnesia;
 * sleep disorders, fatigue;
 * depersonalization.

Anxiety disorder is often also manifested by somatic symptoms:
 * cardiac symptoms: palpitations, tachycardia, chest pain;
 * respiratory difficulties: shortness of breath, psychogenic asthma;
 * gastrointestinal symptoms: loss of appetite, nausea, vomiting, diarrhea;
 * psychogenic pain;
 * neurological symptoms: dizziness, unsteadiness, paraesthesia, muscle tension, loss of sensory functions, swallowing disorders, feelings of "dumpling in the throat";
 * other vegetative symptoms: hot flushes, sweating;
 * inefficiency;
 * self-harm, suicidal tendencies.

Classification according to ICD-10

 * Phobic anxiety disorders 
 * Other anxiety disorders 
 * Obsessive-compulsive disorder 


 * {| class="wikitable"

! !! ICD 10 ! F40!! Phobic anxiety disorders ! F41!! Other anxiety disorders ! F42!! Obsessive Compulsive Disorder
 * F40.0 || Agoraphobia (with/without panic disorder)
 * F40.1 || Social phobia
 * F40.2 || Specific (isolated) phobias
 * F40.8 || Other phobic anxiety disorders
 * F40.9 || Phobic anxiety disorder unspecified
 * F40.2 || Specific (isolated) phobias
 * F40.8 || Other phobic anxiety disorders
 * F40.9 || Phobic anxiety disorder unspecified
 * F40.9 || Phobic anxiety disorder unspecified
 * F40.9 || Phobic anxiety disorder unspecified
 * F41.0 || Panic disorder (episodic paroxysmal anxiety)
 * F41.1 || Generalized anxiety disorder
 * F41.2 || Mixed anxiety-depressive disorder
 * F41.3 || Other mixed anxiety disorders
 * F41.8 || Other specified anxiety disorders
 * F41.9 || Anxiety disorder unspecified
 * F41.3 || Other mixed anxiety disorders
 * F41.8 || Other specified anxiety disorders
 * F41.9 || Anxiety disorder unspecified
 * F41.8 || Other specified anxiety disorders
 * F41.9 || Anxiety disorder unspecified
 * F41.9 || Anxiety disorder unspecified
 * F42.0 || Predominantly intrusive thoughts or ruminations
 * F42.1 || Predominantly compulsive acts (compulsive rituals)
 * F42.2 || Mixed compulsive thoughts and actions
 * F42.8 || Other obsessive-compulsive disorders
 * F42.9 || Obsessive-compulsive disorder, NS
 * }
 * F42.8 || Other obsessive-compulsive disorders
 * F42.9 || Obsessive-compulsive disorder, NS
 * }
 * F42.9 || Obsessive-compulsive disorder, NS
 * }

Treatment
Treatment of anxiety disorders can be both pharmacological and psychotherapeutic.

Pharmacotherapy
 * antidepressants (SSRI, SNRI, RIMA, MAOI, tricyclic),
 * anxiolytics,
 * &beta;-blockers.


 * Psychotherapy
 * Gestalt psychotherapy
 * cognitive behavioral therapy

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