Biological vs. Psychological Treatments of Anxiety Disorders

SummaryIn 1962 William Sargant and his colleagues described the therapeutic value of phenelzine, a monoamine oxidase inhibitor (MAOI), in chronic anxiety disorders and in the same year Klein and Fink reported the treatment of similar conditions with imipramine, a tricyclic antidepressant. Subsequent research has confirmed these findings and demonstrated the range of similar drugs that are effective in anxiety disorders. At the time of these original observations about the drug treatment of anxiety, there were no psychological treatments of proven value but in the intervening years much progress has been made in developing behavioural and cognitive procedures. The progress in determining the mode of action of these pharmacological and psychological treatments is reviewed and the implications of the findings are considered in relation to research into the causes of the anxiety disorders and to the treatment of patients.

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Interaction of pharmacological and psychological treatments of anxiety

The British Journal of Psychiatry ◽

10.1192/s0007125000293513 ◽

1998 ◽

Vol 173 (S34) ◽

pp. 42-48 ◽

Cited By ~ 25

Author(s):

M. H. Lader ◽

A. J. Bond

Keyword(s):

Anxiety Disorders ◽

Psychological Treatment ◽

Combined Treatment ◽

Management Training ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment ◽

Double Blind ◽

Psychological Treatments ◽

Anxiety Management

Background Pharmacological and psychological treatments for anxiety are often combined in clinical practice but there is little research from which to predict the effects.Method The theoretical outcomes of combining treatments and methods of investigating these as well as methodological difficulties are described. Studies which have been completed in anxiety disorders are reviewed. A double-blind trial, using a factorial design, evaluated buspirone v. placebo and anxiety management training v. nondirective therapy in 60 patients with generalised anxiety disorder (GAD).Results Relatively few germane studies have been carried out in the anxiety disorders except for panic disorder with agoraphobia. There is some evidence that short-term, combined treatment does confer additional benefits which are evident both in speed of onset and lasting remission. All four treatment combinations proved effective in the short-term treatment of GAD.Conclusions More studies examining combined treatment are needed. Although differences may not be apparent at the end of the treatment period, psychological treatment appears to confer advantages at follow-up.

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Internet-Delivered Psychological Treatments for Mood and Anxiety Disorders: A Systematic Review of Their Efficacy, Safety, and Cost-Effectiveness

PLoS ONE ◽

10.1371/journal.pone.0098118 ◽

2014 ◽

Vol 9 (5) ◽

pp. e98118 ◽

Cited By ~ 193

Author(s):

Filip K. Arnberg ◽

Steven J. Linton ◽

Monica Hultcrantz ◽

Emelie Heintz ◽

Ulf Jonsson

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Anxiety Disorders ◽

Psychological Treatments ◽

Mood And Anxiety Disorders

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A meta-review of Internet computer-based psychological treatments for anxiety disorders

Journal of Telemedicine and Telecare ◽

10.1177/1357633x15586491 ◽

2015 ◽

Vol 22 (1) ◽

pp. 3-11 ◽

Cited By ~ 14

Author(s):

Wenceslao Peñate ◽

Ascensión Fumero

Keyword(s):

Anxiety Disorders ◽

Psychological Treatments ◽

Meta Review ◽

Computer Based

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The role of prefrontal–subcortical circuitry in negative bias in anxiety: Translational, developmental and treatment perspectives

Brain and Neuroscience Advances ◽

10.1177/2398212818774223 ◽

2018 ◽

Vol 2 ◽

pp. 239821281877422 ◽

Cited By ~ 11

Author(s):

Christina O. Carlisi ◽

Oliver J. Robinson

Keyword(s):

Anxiety Disorders ◽

Psychological Symptom ◽

Developmental Trajectory ◽

Reciprocal Relationship ◽

Negative Bias ◽

Psychological Treatments ◽

Brain Circuitry ◽

Affective Bias ◽

Developed World

Anxiety disorders are the most common cause of mental ill health in the developed world, but our understanding of symptoms and treatments is not presently grounded in knowledge of the underlying neurobiological mechanisms. In this review, we discuss accumulating work that points to a role for prefrontal–subcortical brain circuitry in driving a core psychological symptom of anxiety disorders – negative affective bias. Specifically, we point to converging work across humans and animal models, suggesting a reciprocal relationship between dorsal and ventral prefrontal–amygdala circuits in promoting and inhibiting negative bias, respectively. We discuss how the developmental trajectory of these circuits may lead to the onset of anxiety during adolescence and, moreover, how effective pharmacological and psychological treatments may serve to shift the balance of activity within this circuitry to ameliorate negative bias symptoms. Together, these findings may bring us closer to a mechanistic, neurobiological understanding of anxiety disorders and their treatment.

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