Table Of Content

The American Psychiatric Publishing Textbook of Anxiety Disorders This page intentionally left blank The American Psychiatric Publishing Textbook of Anxiety Disorders Edited by Dan J. Stein, M.D., Ph.D. Eric Hollander, M.D. Washington, DC London, England Note: The authors have worked to ensure that all information in this book concerning drug dosages, schedules, and routes of administration is accurate as of the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice advance, however, therapeutic standards may change. For this reason and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of a physician who is directly involved in their care or the care of a member of their family. A product’s current package insert should be consulted for full prescribing and safety information. Books published by American Psychiatric Publishing, Inc., represent the views and opinions of the individual authors and do not necessarily represent the policies and opinions of APPI or the American Psychiatric Association. Copyright © 2002 American Psychiatric Publishing, Inc. ALL RIGHTS RESERVED Manufactured in the United States of America on acid-free paper 05 04 03 02 4 3 2 1 First Edition American Psychiatric Publishing, Inc. 1400 K Street, N.W. Washington, DC 20005 www.appi.org Library of Congress Cataloging-in-Publication Data The American Psychiatric Publishing textbook of anxiety disorders / edited by Dan J. Stein, Eric Hollander. — 1st ed. p. ; cm. Includes bibliographical references and index. ISBN 0-88048-829-8 (alk. paper) 1. Anxiety. I. Stein, Dan J. II. Hollander, Eric, 1957- [DNLM: 1. Anxiety Disorders. WM 172 T356 2001] RC531 .T47 2001 616.85′223—dc21 2001022187 British Library Cataloguing in Publication Data A CIP record is available from the British Library. Contents Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xvii PART I Approaching the Anxiety Disorders 1 History of AnxietyDisorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Michael H. Stone, M.D. 2 Classification of AnxietyDisorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 Timothy A. Brown, Psy.D. 3 Preclinical ModelsofAnxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 Lotta Arborelius, Ph.D. Charles B. Nemeroff, M.D., Ph.D. 4 Neural Circuits in FearandAnxiety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 J. Douglas Bremner, M.D. Dennis S. Charney, M.D. 5 Evolutionary ConceptsofAnxiety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57 Myron A. Hofer, M.D. 6 Cognitive ConceptsofAnxiety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71 Arthur Freeman, Ed.D., A.B.P.P. Robert A. DiTomasso, Ph.D., A.B.P.P. 7 Psychodynamic ConceptsofAnxiety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 Barbara Milrod, M.D. Arnold M. Cooper, M.D. M. Katherine Shear, M.D. 8 Combined Treatment for Anxiety Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93 James M. Ellison, M.D., M.P.H. R. Harris G. McCarter, Ph.D. PART II Generalized Anxiety Disorder 9 Phenomenology of Generalized Anxiety Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109 Laszlo A. Papp, M.D. Marc S. Kleber, Ph.D. 10 Pathogenesis of Generalized Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119 Thomas E. Brouette, M.D. Andrew W. Goddard, M.D. 11 Pharmacotherapy for Generalized Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 Norman Sussman, M.D. Dan J. Stein, M.D., Ph.D. 12 Psychotherapy for Generalized Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141 Jonathan D. Huppert, Ph.D. William C. Sanderson, Ph.D. PART III Mixed Anxiety- Depressive Disorder 13 Mixed Anxiety-DepressiveDisorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159 Rebecca P. Cameron, Ph.D. Alan F. Schatzberg, M.D. PART IV Obsessive-Compulsive Disorder and Related Disorders 14 Phenomenology of Obsessive-Compulsive Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173 Jane L. Eisen, M.D. Steven A. Rasmussen, M.D. 15 Pathogenesis of Obsessive-Compulsive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .191 Scott L. Rauch, M.D. Gabriela Corá-Locatelli, M.D. Benjamin D. Greenberg, M.D., Ph.D. 16 Pharmacotherapy for Obsessive-Compulsive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207 Wayne K. Goodman, M.D. 17 Psychotherapy for Obsessive-Compulsive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .221 John H. Greist, M.D. Lee Baer, Ph.D. PART V Panic Disorder and Agoraphobia 18 Phenomenology of PanicDisorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .237 Mark H. Pollack, M.D. Jordan W. Smoller, M.D., Sc.D. Michael W. Otto, Ph.D. Erin L. Scott, M.A. Jerrold F. Rosenbaum, M.D. 19 Pathogenesis of PanicDisorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .247 Jeremy D. Coplan, M.D. Jack M. Gorman, M.D. 20 Pharmacotherapy for PanicDisorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257 R. Bruce Lydiard, M.D., Ph.D. 21 Psychotherapy for PanicDisorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .273 David A. Spiegel, M.D. Stefan G. Hofmann, Ph.D. PART VI Social Phobia 22 Phenomenology of SocialPhobia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .289 Denise A. Chavira, Ph.D. Murray B. Stein, M.D., F.R.C.P.C. 23 Pathogenesis of SocialPhobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .301 Manuel E. Tancer, M.D. Thomas W. Uhde, M.D. 24 Pharmacotherapy for SocialPhobia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .309 Carlos Blanco, M.D., Ph.D. Franklin R. Schneier, M.D. Michael R. Liebowitz, M.D. 25 Psychotherapy for SocialPhobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .323 Cynthia L. Turk, Ph.D. Meredith E. Coles, M.A. Richard G. Heimberg, Ph.D. PART VII Specific Phobia 26 Specific Phobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .343 Allison G. Harvey, Ph.D. Ronald M. Rapee, Ph.D. PART VIII Posttraumatic Stress Disorder and Acute Stress Disorder 27 Phenomenology of Posttraumatic StressDisorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .359 Alexander C. McFarlane, M.D. 28 Pathogenesis of Posttraumatic Stress Disorder and Acute StressDisorder . . . . . . . . . . . . . . . . . . .373 Rachel Yehuda, Ph.D. Cheryl M. Wong, M.D. 29 Pharmacotherapy for Posttraumatic StressDisorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .387 Barbara A. Crockett, M.D. Jonathan R. T. Davidson, M.D. 30 Psychotherapy for Posttraumatic Stress Disorder and Other Trauma-Related Disorders . . . . . . .403 Bessel A. van der Kolk, M.D. Alexander C. McFarlane, M.D. Onno van der Hart, Ph.D. PART IX Anxiety Disorders in Special Populations 31 Anxiety Disorders in Children and Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .415 John S. March, M.D., M.P.H. Anne Marie Albano, Ph.D. 32 Anxiety Disorders in the Elderly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .429 Debra B. Kaminer, M.Psych. Soraya Seedat, M.B., F.C.Psych., M.Med.(Psych) Felix Potocnik, M.B., F.C.Psych. Dan J. Stein, M.D., Ph.D. 33 Anxiety in the Context of Substance Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .441 Leonard Handelsman, M.D. 34 Anxiety and Anxiety Disorders in MedicalSettings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .449 Michael J. Raster, M.D. Thomas N. Wise, M.D. June Cai, M.D. PART X Social Aspects of Anxiety Disorders 35 Cultural and Social Aspectsof Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .463 Dan J. Stein, M.D., Ph.D. David R. Williams, Ph.D. 36 Economic Costs of AnxietyDisorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .475 Robert L. DuPont, M.D. Caroline M. DuPont, M.D. Dorothy P. Rice, Sc.D. (Hon.) 37 Consumer Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .485 Jerilyn Ross, M.A., L.I.C.S.W. Appendix: Internet Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .493 Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .495

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Anxiety disorders are at once among the most disabling and the most prevalent of the psychiatric disorders—more common than either mood or substance use disorders. Often misdiagnosed and undertreated—perhaps because it is often difficult for patients to seek help and for caregivers to appreciate
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The American Psychiatric publishing textbook of anxiety disorders PDF

534 Pages·2002·4.2 MB·English
by  Dan J. Stein
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The American Psychiatric Publishing Textbook of Anxiety Disorders This page intentionally left blank The American Psychiatric Publishing Textbook of Anxiety Disorders Edited by Dan J. Stein, M.D., Ph.D. Eric Hollander, M.D. Washington, DC London, England Note: The authors have worked to ensure that all information in this book concerning drug dosages, schedules, and routes of administration is accurate as of the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice advance, however, therapeutic standards may change. For this reason and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of a physician who is directly involved in their care or the care of a member of their family. A product’s current package insert should be consulted for full prescribing and safety information. Books published by American Psychiatric Publishing, Inc., represent the views and opinions of the individual authors and do not necessarily represent the policies and opinions of APPI or the American Psychiatric Association. Copyright © 2002 American Psychiatric Publishing, Inc. ALL RIGHTS RESERVED Manufactured in the United States of America on acid-free paper 05 04 03 02 4 3 2 1 First Edition American Psychiatric Publishing, Inc. 1400 K Street, N.W. Washington, DC 20005 www.appi.org Library of Congress Cataloging-in-Publication Data The American Psychiatric Publishing textbook of anxiety disorders / edited by Dan J. Stein, Eric Hollander. — 1st ed. p. ; cm. Includes bibliographical references and index. ISBN 0-88048-829-8 (alk. paper) 1. Anxiety. I. Stein, Dan J. II. Hollander, Eric, 1957- [DNLM: 1. Anxiety Disorders. WM 172 T356 2001] RC531 .T47 2001 616.85′223—dc21 2001022187 British Library Cataloguing in Publication Data A CIP record is available from the British Library. Contents Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xvii PART I Approaching the Anxiety Disorders 1 History of AnxietyDisorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Michael H. Stone, M.D. 2 Classification of AnxietyDisorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 Timothy A. Brown, Psy.D. 3 Preclinical ModelsofAnxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 Lotta Arborelius, Ph.D. Charles B. Nemeroff, M.D., Ph.D. 4 Neural Circuits in FearandAnxiety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 J. Douglas Bremner, M.D. Dennis S. Charney, M.D. 5 Evolutionary ConceptsofAnxiety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57 Myron A. Hofer, M.D. 6 Cognitive ConceptsofAnxiety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71 Arthur Freeman, Ed.D., A.B.P.P. Robert A. DiTomasso, Ph.D., A.B.P.P. 7 Psychodynamic ConceptsofAnxiety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 Barbara Milrod, M.D. Arnold M. Cooper, M.D. M. Katherine Shear, M.D. 8 Combined Treatment for Anxiety Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93 James M. Ellison, M.D., M.P.H. R. Harris G. McCarter, Ph.D. PART II Generalized Anxiety Disorder 9 Phenomenology of Generalized Anxiety Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109 Laszlo A. Papp, M.D. Marc S. Kleber, Ph.D. 10 Pathogenesis of Generalized Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119 Thomas E. Brouette, M.D. Andrew W. Goddard, M.D. 11 Pharmacotherapy for Generalized Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 Norman Sussman, M.D. Dan J. Stein, M.D., Ph.D. 12 Psychotherapy for Generalized Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141 Jonathan D. Huppert, Ph.D. William C. Sanderson, Ph.D. PART III Mixed Anxiety- Depressive Disorder 13 Mixed Anxiety-DepressiveDisorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159 Rebecca P. Cameron, Ph.D. Alan F. Schatzberg, M.D. PART IV Obsessive-Compulsive Disorder and Related Disorders 14 Phenomenology of Obsessive-Compulsive Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173 Jane L. Eisen, M.D. Steven A. Rasmussen, M.D. 15 Pathogenesis of Obsessive-Compulsive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .191 Scott L. Rauch, M.D. Gabriela Corá-Locatelli, M.D. Benjamin D. Greenberg, M.D., Ph.D. 16 Pharmacotherapy for Obsessive-Compulsive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207 Wayne K. Goodman, M.D. 17 Psychotherapy for Obsessive-Compulsive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .221 John H. Greist, M.D. Lee Baer, Ph.D. PART V Panic Disorder and Agoraphobia 18 Phenomenology of PanicDisorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .237 Mark H. Pollack, M.D. Jordan W. Smoller, M.D., Sc.D. Michael W. Otto, Ph.D. Erin L. Scott, M.A. Jerrold F. Rosenbaum, M.D. 19 Pathogenesis of PanicDisorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .247 Jeremy D. Coplan, M.D. Jack M. Gorman, M.D. 20 Pharmacotherapy for PanicDisorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257 R. Bruce Lydiard, M.D., Ph.D. 21 Psychotherapy for PanicDisorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .273 David A. Spiegel, M.D. Stefan G. Hofmann, Ph.D. PART VI Social Phobia 22 Phenomenology of SocialPhobia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .289 Denise A. Chavira, Ph.D. Murray B. Stein, M.D., F.R.C.P.C. 23 Pathogenesis of SocialPhobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .301 Manuel E. Tancer, M.D. Thomas W. Uhde, M.D. 24 Pharmacotherapy for SocialPhobia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .309 Carlos Blanco, M.D., Ph.D. Franklin R. Schneier, M.D. Michael R. Liebowitz, M.D. 25 Psychotherapy for SocialPhobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .323 Cynthia L. Turk, Ph.D. Meredith E. Coles, M.A. Richard G. Heimberg, Ph.D. PART VII Specific Phobia 26 Specific Phobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .343 Allison G. Harvey, Ph.D. Ronald M. Rapee, Ph.D. PART VIII Posttraumatic Stress Disorder and Acute Stress Disorder 27 Phenomenology of Posttraumatic StressDisorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .359 Alexander C. McFarlane, M.D. 28 Pathogenesis of Posttraumatic Stress Disorder and Acute StressDisorder . . . . . . . . . . . . . . . . . . .373 Rachel Yehuda, Ph.D. Cheryl M. Wong, M.D. 29 Pharmacotherapy for Posttraumatic StressDisorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .387 Barbara A. Crockett, M.D. Jonathan R. T. Davidson, M.D. 30 Psychotherapy for Posttraumatic Stress Disorder and Other Trauma-Related Disorders . . . . . . .403 Bessel A. van der Kolk, M.D. Alexander C. McFarlane, M.D. Onno van der Hart, Ph.D. PART IX Anxiety Disorders in Special Populations 31 Anxiety Disorders in Children and Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .415 John S. March, M.D., M.P.H. Anne Marie Albano, Ph.D. 32 Anxiety Disorders in the Elderly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .429 Debra B. Kaminer, M.Psych. Soraya Seedat, M.B., F.C.Psych., M.Med.(Psych) Felix Potocnik, M.B., F.C.Psych. Dan J. Stein, M.D., Ph.D. 33 Anxiety in the Context of Substance Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .441 Leonard Handelsman, M.D. 34 Anxiety and Anxiety Disorders in MedicalSettings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .449 Michael J. Raster, M.D. Thomas N. Wise, M.D. June Cai, M.D. PART X Social Aspects of Anxiety Disorders 35 Cultural and Social Aspectsof Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .463 Dan J. Stein, M.D., Ph.D. David R. Williams, Ph.D. 36 Economic Costs of AnxietyDisorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .475 Robert L. DuPont, M.D. Caroline M. DuPont, M.D. Dorothy P. Rice, Sc.D. (Hon.) 37 Consumer Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .485 Jerilyn Ross, M.A., L.I.C.S.W. Appendix: Internet Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .493 Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .495

Description:
Anxiety disorders are at once among the most disabling and the most prevalent of the psychiatric disorders—more common than either mood or substance use disorders. Often misdiagnosed and undertreated—perhaps because it is often difficult for patients to seek help and for caregivers to appreciate
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