Epidemiology
Etiology
Classifications
| Disorder | Defining Feature | Key Differentiator | Dx & Tx |
|---|---|---|---|
| Social Anxiety | Fear of scrutiny/embarrassment in social or performance situations. | Fear is specific to social contexts; performance-only subtype exists. | ≥6 mo; Tx: SSRI/SNRI, CBT. Propranolol for performance type. |
| Panic Disorder | Recurrent, discrete, unexpected panic attacks. | ”Fear of the fear”—persistent worry about having more attacks. | ≥1 mo of worry/avoidance after attack; Tx: SSRI/SNRI, CBT. BZDs for acute attacks. |
| Specific Phobia | Marked, irrational fear of a specific object or situation (e.g., spiders, heights). | Fear is immediate & predictable upon exposure to the trigger. | ≥6 mo; Tx: CBT with exposure is first-line. |
| Acute Stress Disorder | PTSD-like sx (intrusion, avoidance, arousal) after a traumatic event. | Duration is key: symptoms last from 3 days to 1 month post-trauma. | Dx based on timing; Tx: Trauma-focused CBT. |
| GAD | Excessive, chronic, constant worry about multiple life domains (work, money, health). | Worry is “free-floating,” not focused on one trigger; physical sx like muscle tension, fatigue. | ≥6 mo; Tx: SSRI/SNRI, Buspirone, CBT. |
| Agoraphobia | Fear of ≥2 situations where escape is difficult (e.g., crowds, open spaces, public transport). | Fear is about being trapped or unable to get help if anxiety occurs; leads to avoidance. | ≥6 mo; Tx: SSRI/SNRI, CBT. |
Clinical features
Diagnostics
Treatment
Psychotherapy
- CBT (preferred)
Pharmacotherapy
- First-line agents
- SSRIs
- SNRIs
- Alternative agents
- Buspirone
- Benzodiazepines for short-term use only
- TCAs, e.g., imipramine
Warning
Long-term use of benzodiazepines is associated with significant adverse effects (e.g., motor and cognitive impairment) and risk of dependence.