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Anxiety Disorders in Adults A Clinical Guide, Second Edition by Vladan Starcevic MD PhD

By Vladan Starcevic MD PhD

Utilizing the sensible but entire method present in the 1st version, the writer considers every one nervousness disorder's medical complexity whereas concurrently utilizing an integrative orientation towards discovering medical ideas. the writer considers the presentation of every affliction because it happens and is handled within the "real global" of scientific perform. eventually, the quantity addresses potent healing systems and proposals, together with pharmacological and mental remedy ways. a real "must learn" for any psychiatrist attracted to anxiousness problems.

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Traveling far away by themselves). , crowds and trains in motion). , a social function that a patient would feel an urge to leave immediately). The unique feature of agoraphobia is the multiple situations and/or places that are feared and avoided. Also, patients with agoraphobia may avoid more and more situations with the passage of time. The ‘‘profile’’ of the avoided situations may differ greatly from one patient to another and depends on the underlying themes described above. Local circumstances may determine whether patients with agoraphobia exhibit prominent avoidance of the specific situations or places, such as bridges, tunnels, or a subway, and whether they are disabled by such avoidance.

The issues arising from combining pharmacotherapy and cognitive-behavioral therapy are addressed in more detail in Chapter 2. Patient presenting for treatment Able to tolerate anxiety/distress? Yes No CBT Pharmacotherapy Good response? No Consider adding pharmacotherapy Motivated for CBT? Yes Continue CBT only Yes No Add CBT, while disContinue continuing pharmacopharmacotherapy or continuing therapy only concomitant pharmacotherapy for some time Figure 1–3. Initial and subsequent choice of treatment in anxiety disorders (simplified).

Panic Disorder and Personality Disturbance The relationship between panic disorder and personality disturbance is important because of the implications it may have for the understanding of the psychopathology of panic disorder and for its treatment. Most personality disorders and personality traits that have been found in patients with panic disorder are nonspecifically associated with panic disorder. That is, the same or similar types of the personality-level psychopathology have been found in patients with other anxiety disorders and depression.

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