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Section 4 - Treatment of anxiety: current status and controversial issues

Published online by Cambridge University Press:  10 November 2010

Edited by
Helen Blair Simpson ,
Yuval Neria ,
Roberto Lewis-Fernández  and
Franklin Schneier
Helen Blair Simpson
Affiliation:
Columbia University, New York
Yuval Neria
Affiliation:
Columbia University, New York
Roberto Lewis-Fernández
Affiliation:
Columbia University, New York
Franklin Schneier
Affiliation:
Columbia University, New York
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Summary

Obsessive-compulsive disorder (OCD) is a severe and debilitating illness. This chapter examines the available evidence regarding choosing a treatment modality, efficacy within modality classes, special groups, and augmentation strategies. It also reviews the latest advances in treatment. Cognitive-behavioral therapy (CBT) and serotonin reuptake inhibitors (SRI) monotherapy have each been shown in multiple randomized controlled trials to be efficacious for adults with OCD. Other than pharmacotherapy with a serotonin reuptake inhibitor, CBT is the only other first-line treatment for adults. New horizons for research include development of clinical correlates, or endophenotypes, of OCD symptoms in order to understand the underlying mechanism of disease. Translational approaches, such as developing mouse models of OCD and neuroimaging of the serotonin, dopamine, and glutamate neurotransmitter systems, will help us to understand better how neural substrates are linked to OCD and how our treatments affect these neural systems and reduce OCD symptoms.

Keywords

anxiety disordersautonomic nervous systemcatastrophic cognitionspost-traumatic stress disorderpanic disordercultural illness syndromesidioms of distress
Type
Chapter
Information
Anxiety Disorders
Theory, Research and Clinical Perspectives
 , pp. 249 - 361
Publisher: Cambridge University Press
Print publication year: 2010

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