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Anxiety disorders and comorbid medical illness.

Abstract

OBJECTIVE

To provide an overview of the role of anxiety disorders in medical illness.

METHOD

The Anxiety Disorders Association of America held a multidisciplinary conference from which conference leaders and speakers reviewed presentations and discussions, considered literature on prevalence, comorbidity, etiology and treatment, and made recommendations for research. Irritable bowel syndrome (IBS), asthma, cardiovascular disease (CVD), cancer and chronic pain were reviewed.

RESULTS

A substantial literature supports clinically important associations between psychiatric illness and chronic medical conditions. Most research focuses on depression, finding that depression can adversely affect self-care and increase the risk of incident medical illness, complications and mortality. Anxiety disorders are less well studied, but robust epidemiological and clinical evidence shows that anxiety disorders play an equally important role. Biological theories of the interactions between anxiety and IBS, CVD and chronic pain are presented. Available data suggest that anxiety disorders in medically ill patients should not be ignored and could be considered conjointly with depression when developing strategies for screening and intervention, particularly in primary care.

CONCLUSIONS

Emerging data offer a strong argument for the role of anxiety in medical illness and suggest that anxiety disorders rival depression in terms of risk, comorbidity and outcome. Research programs designed to advance our understanding of the impact of anxiety disorders on medical illness are needed to develop evidence-based approaches to improving patient care.

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  • Authors+Show Affiliations

    ,

    University of Washington School of Medicine, Seattle, WA 98195, USA. roybyrne@u.washington.edu

    , , , , , , , , ,

    Source

    MeSH

    Anti-Anxiety Agents
    Anxiety Disorders
    Asthma
    Cardiovascular Diseases
    Chronic Disease
    Cognitive Behavioral Therapy
    Combined Modality Therapy
    Comorbidity
    Cross-Sectional Studies
    Depressive Disorder
    Humans
    Irritable Bowel Syndrome
    Neoplasms
    Pain
    Pain Management
    Risk Factors
    Serotonin Uptake Inhibitors

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    18433653

    Citation

    Roy-Byrne, Peter P., et al. "Anxiety Disorders and Comorbid Medical Illness." General Hospital Psychiatry, vol. 30, no. 3, 2008, pp. 208-25.
    Roy-Byrne PP, Davidson KW, Kessler RC, et al. Anxiety disorders and comorbid medical illness. Gen Hosp Psychiatry. 2008;30(3):208-25.
    Roy-Byrne, P. P., Davidson, K. W., Kessler, R. C., Asmundson, G. J., Goodwin, R. D., Kubzansky, L., ... Stein, M. B. (2008). Anxiety disorders and comorbid medical illness. General Hospital Psychiatry, 30(3), pp. 208-25. doi:10.1016/j.genhosppsych.2007.12.006.
    Roy-Byrne PP, et al. Anxiety Disorders and Comorbid Medical Illness. Gen Hosp Psychiatry. 2008;30(3):208-25. PubMed PMID: 18433653.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Anxiety disorders and comorbid medical illness. AU - Roy-Byrne,Peter P, AU - Davidson,Karina W, AU - Kessler,Ronald C, AU - Asmundson,Gordon J G, AU - Goodwin,Renee D, AU - Kubzansky,Laura, AU - Lydiard,R Bruce, AU - Massie,Mary Jane, AU - Katon,Wayne, AU - Laden,Sally K, AU - Stein,Murray B, PY - 2007/10/24/received PY - 2007/12/11/revised PY - 2007/12/11/accepted PY - 2008/4/25/pubmed PY - 2008/8/12/medline PY - 2008/4/25/entrez SP - 208 EP - 25 JF - General hospital psychiatry JO - Gen Hosp Psychiatry VL - 30 IS - 3 N2 - OBJECTIVE: To provide an overview of the role of anxiety disorders in medical illness. METHOD: The Anxiety Disorders Association of America held a multidisciplinary conference from which conference leaders and speakers reviewed presentations and discussions, considered literature on prevalence, comorbidity, etiology and treatment, and made recommendations for research. Irritable bowel syndrome (IBS), asthma, cardiovascular disease (CVD), cancer and chronic pain were reviewed. RESULTS: A substantial literature supports clinically important associations between psychiatric illness and chronic medical conditions. Most research focuses on depression, finding that depression can adversely affect self-care and increase the risk of incident medical illness, complications and mortality. Anxiety disorders are less well studied, but robust epidemiological and clinical evidence shows that anxiety disorders play an equally important role. Biological theories of the interactions between anxiety and IBS, CVD and chronic pain are presented. Available data suggest that anxiety disorders in medically ill patients should not be ignored and could be considered conjointly with depression when developing strategies for screening and intervention, particularly in primary care. CONCLUSIONS: Emerging data offer a strong argument for the role of anxiety in medical illness and suggest that anxiety disorders rival depression in terms of risk, comorbidity and outcome. Research programs designed to advance our understanding of the impact of anxiety disorders on medical illness are needed to develop evidence-based approaches to improving patient care. SN - 0163-8343 UR - https://www.unboundmedicine.com/medline/citation/18433653/Anxiety_disorders_and_comorbid_medical_illness_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-8343(07)00259-9 DB - PRIME DP - Unbound Medicine ER -