Anxiety Disorders Edited by D.J. Nutt DM FRCP FRCPsych F.Med.Sci Psychopharmacology Unit School of Medical Sciences University of Bristol Bristol, UK J.C. Ballenger MD Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston SC, USA Blackwell Science Anxiety Disorders Anxiety Disorders Edited by D.J. Nutt DM FRCP FRCPsych F.Med.Sci Psychopharmacology Unit School of Medical Sciences University of Bristol Bristol, UK J.C. Ballenger MD Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston SC, USA Blackwell Science © 2003 by Blackwell Science Ltd a Blackwell Publishing company Blackwell Science, Inc., 350 Main Street, Malden, Massachusetts 02148–5018, USA Blackwell Science Ltd, Osney Mead, Oxford OX2 0EL, UK Blackwell Science Asia Pty Ltd, 550 Swanston Street, Carlton South, Victoria 3053, Australia Blackwell Wissenschafts Verlag, Kurfürstendamm 57, 10707 Berlin, Germany The right of the Author to be identified as the Author of this Work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. First published 2002 Library of Congress Cataloging-in-Publication Data Anxiety disorders / edited by D.J. Nutt, J.C. Ballenger. p. ; cm. Includes index. ISBN 0–632–05938–9 1. Anxiety. [DNLM: 1. Anxiety Disorders. 2. Anxiety Disorders—drug therapy. WM 172 A63719 2002] I. Nutt, David J., 1951– II. Ballenger, James C. RC531 .A6118 2002 616.85′223061—dc21 2002009821 A catalogue record for this title is available from the British Library Set in 9/111/2pt Sabon Graphicraft Limited, Hong Kong Printed and bound in Great Britain, at the Bath Press, Bath, UK Commissioning Editor: Stuart Taylor Editorial Assistant: Rupal Malde Production Editor: Rebecca Muxley Production Controller: Chris Downs For further information on Blackwell Science, visit our website: http://www.blackwellpublishing.com Contents Contributors, vii Preface, xi Part 1: Introduction 1 Conceptual Antecedents of the Anxiety Disorders, 3 R.D. Marshall & D.F. Klein Part 2: Symptoms and Syndromes 2 Relationships Among Anxiety Disorders: Patterns and Implications, 25 H.-U. Wittchen, Y. Lecrubier, K. Beesdo & A. Nocon 3 Panic Disorder: Symptoms and Syndromes, 39 S. S. Sinha & J. Gorman 4 Generalized Anxiety Disorder, 51 J. Monnier & O. Brawman-Mintzer 5 Post-traumatic Stress Disorder, 65 S.A.M. Rauch & E.B. Foa 6 Obsessive-compulsive Disorder, 83 J. Zohar, Y. Sasson, M. Chopra, R. Amiaz & N. Nakash 7 Social Anxiety Disorder, 95 P.L. du Toit & D.J. Stein 8 Sleep Aspects of Anxiety Disorders, 125 T.A. Mellman 9 Childhood Antecedents of Adult Anxiety Disorders, 135 S.J. Fredman, D.R. Hirshfeld-Becker, J.W. Smoller & J.F. Rosenbaum 10 Anxiety and Schizophrenia, 163 R.A. Emsley & D.J. Stein Part 3: Mechanisms 11 Neurochemical Aspects of Anxiety, 183 S.V. Argyropoulos & D.J. Nutt 12 Brain Imaging and Anxiety Disorders, 201 A.L. Malizia 13 Genetic Dissection of Anxiety and Related Disorders, 229 K.P. Lesch 14 Respiration and Anxiety, 251 E. Griez & G. Perna 15 Pharmacological Challenge Agents in Anxiety, 269 J. Swain, D. Koszycki, J. Shlik & J. Bradwejn v CONTENTS 16 Panic Disorder and Medical Illness, 297 T.S. Zaubler & W. Katon Part 4: Treatments 17 Benzodiazepines, 315 C. Faravelli, S. Rosi & E. Truglia 18 Selective Serotonin Reuptake Inhibitors in the Treatment of the Anxiety Disorders, 339 J.C. Ballenger 19 Treatment of Anxiety Disorders with Tricyclic Antidepressants, 363 R. Rosenberg 20 Buspirone in the Treatment of Anxiety Disorders, 381 K. Rickels, S. Khalid-Khan & M. Rynn 21 Antihistamines in the Treatment of Psychic and Somatic Anxiety States, 399 M.M.M.P. Van Moffaert 22 Anxiety Disorders: New Antidepressants, 411 R.B. Hidalgo & J.R.T. Davidson 23 Cognitive Behavioral Treatment of Anxiety Disorders, 425 S.A. Falsetti, A. Combs-Lane & J.L. Davis 24 Exposure Therapy in the Treatment of Anxiety Disorders, 445 S.P. Cahill & E.B. Foa 25 Anxiety Disorders: Alternative Drug Treatments, 463 N. Laufer, S. Gur, R. Gross-Isseroff & A. Weizman 26 Physical Treatments, 481 T.E. Schlaepfer & B.D. Greenberg 27 Herbal Therapy and Anxiety, 491 M. Bourin Part 5: Conclusion 28 Anxiety Disorders: Current Needs and Future Prospects, 501 D. Nutt & J. Ballenger Index, 511 vi Contributors R. Amiaz M. Chopra Department of Psychiatry Department of Psychiatry Sheba Medical Center Sheba Medical Center Israel Israel S.V. Argyropoulos A. Combs-Lane Psychopharmacology Unit Department of Behavioral Medicine and Psychiatry School of Medical science West Virginia School of Medicine University Walk West Virginia, USA University of Bristol Bristol, UK J.R.T. Davidson Department of Psychiatry and Behavioral Sciences J.C. Ballenger Duke University Medical Center Department of Psychiatry and Behavioral Sciences Durham NC , USA Medical University of South Carolina Charleston SC, USA J.L. Davis Department of Psychology K. Beesdo University of Tulsa, Institute of Clinical Psychology and Psychotherapy Tulsa OK, USA Technical University of Dresden München, Germany R.A. Emsley Department of Psychiatry M. Bourin University of Stellenbosch EA 3256 Neurobiologie de l’anxiété et de la Cape Town, South Africa dépression Faculté de Médecine, BP 5350, 44035 Nantes S.A. Falsetti Cedex 1, France National Crime Victims Research and Treatment Center J. Bradwejn Department of Psychiatry and Behavioral Sciences Department of Psychiatry Medical University of South Carolina University of Ottawa Charleston SC, USA Ottawa, Ontario, Canada C. Faravelli O. Brawman-Mintzer Department of Neurology and Psychiatry Department of Psychiatry and Behavioral Sciences University of Florence Medical University of South Carolina Florence, Italy Charleston SC, USA E.B. Foa S.P. Cahill Department of Psychiatry Department of Psychiatry Center for the Treatment and Study of Anxiety University of Pennsylvania University of Pennsylvania Philadelphia PA, USA Philadelphia PA, USA vii CONTRIBUTORS S.J. Fredman S. Khalid-Khan University of North Carolina at Chapel Hill Mood and Anxiety Disorders Section Chapel Hill NC, USA Department of Psychiatry University of Pennsylvania J. Gorman Philadelphia PA, USA Department of Psychiatry University of Columbia D.F. Klein New York NY, USA Columbia University College of Physicians and Surgeons B.D. Greenberg New York NY, USA Department of Psychiatry and Human Behavior Brown University D. Koszycki Providence RI, USA Department of Psychiatry University of Ottawa E. Griez Ottawa, Ontario, Canada University of Maastricht Department of Psychiatry and Neuropsychology N. Laufer 6200 MD Maastricht, The Netherlands Outpatient Department and Department of Research Geha Psychiatric Hospital R. Gross-Isseroff Petah Tiqva and Sackler Faculty of Medicine Outpatient Department and Department of Research Tel Aviv University Geha Psychiatric Hospital Tel Aviv, Israel Petah Tiqva and Sackler Faculty of Medicine Tel Aviv University Y. Lecrubier Tel Aviv, Israel Hôpital de la Salpétrière, INSERM Unité 302 Paris, France S. Gur Outpatient Department K.P. Lesch Geha Psychiatric Hospital Department of Psychiatry and Psychotherapy Petah Tiqva and Sackler Faculty of Medicine University of Würzburg Tel Aviv University Füchsleinstr. 15 Tel Aviv, Israel 97080 Würzburg, Germany R.B. Hidalgo A.L. Malizia Department of Psychiatry and Behavioral Sciences Psychopharmacology Unit Duke University University of Bristol Durham NC, USA University Walk Bristol, UK D.R. Hirshfeld-Becker Pediatric Psychopharmacology Unit R.D. Marshall Massachusetts General Hospital Trauma Studies, Anxiety Disorders Clinic Department of Psychiatry Columbia University College of Physicians and Harvard Medical School Surgeons Boston MA, USA New York NY, USA W. Katon T.A. Mellman Department of Psychiatry and Behavioral Sciences Dartmouth Medical School University of Washington School of Medicine Department of Psychiatry Seattle WA, USA Lebanon, New Hampshire, USA viii CONTRIBUTORS J. Monnier Psychiatric University Hospital in Aarhus Department of Psychiatry and Behavioral Sciences DK-8240 Risskov Medical University of South Carolina Denmark Charleston SC, USA S. Rosi N. Nakash Department of Neurology and Psychiatry Department of Psychiatry University of Florence Sheba Medical Center Florence, Italy Israel M. Rynn A. Nocon Mood and Anxiety Disorders Section Institute of Clinical Psychology and Psychotherapy Department of Psychiatry Technical University of Dresden and Max Planck University of Pennsylvania Institute of Psychiatry Philadelphia PA, USA München, Germany Y. Sasson D.J. Nutt Department of Psychiatry Psychopharmacology Unit Sheba Medical Center University of Bristol Israel Bristol, UK T.E. Schlaepfer G. Perna Psychiatric Neuroimaging Group Anxiety Disorders Clinical and Research Unit University Hospital Bern Vita-Salute University, San Raffaele Hospital Switzerland Milan, Italy and Division of Psychiatric Neuroimaging S.A.M. Rauch Department of Psychiatry Center for the Treatment and Study of Anxiety The Johns Hopkins Hospital Department of Psychiatry Baltimore MD, USA University of Pennsylvania, J. Shlik Philadelphia PA, USA Department of Psychiatry K. Rickels University of Tartu Mood and Anxiety Disorders Section Tartu, Estonia Department of Psychiatry S.S. Sinha University of Pennsylvania Philadelphia PA, USA Department of Psychiatry Columbia University J.F. Rosenbaum New York NY, USA Chief of Psychiatry J.W. Smoller Massachusetts General Hospital Department of Psychiatry Psychiatric Genetics Program in Mood and Anxiety Harvard Medical School Disorders Boston MA, USA Outpatient Psychiatry Division Massachusetts General Hospital R. Rosenberg Department of Psychiatry Department of Biological Psychiatry Harvard Medical School Institute for Basic Psychiatric Research Boston MA, USA ix