Consensus statement on generalized anxiety disorder from the International Consensus Group on Depression and Anxiety.
OBJECTIVE
To provide primary care clinicians with a better understanding of management issues in generalized anxiety disorder (GAD) and guide clinical practice with recommendations on the appropriate treatment strategy.


METHODS
The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R.T. Davidson, Yves Lecrubier, and David J. Nutt. Four additional faculty members invited by the chair were Karl Rickels, Hans-Ulrich Wittchen, Dan J. Stein, and Thomas D. Borkovec.


METHODS
The consensus statement is based on the 6 review articles that are published in this supplement and the scientific literature relevant to the issues reviewed in these articles.


METHODS
Group meetings were held over a 2-day period. On day 1, the group discussed the review articles and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees.


CONCLUSIONS
GAD is the most common anxiety disorder in primary care and is highly debilitating. Furthermore, it is frequently comorbid with depression and other anxiety disorders, which exacerbates functional impairment. Antidepressants (serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and nonsedating tricyclic antidepressants) are generally the most appropriate first-line pharmacotherapy for GAD, since they are also effective against comorbid psychiatric disorders and are suitable for long-term use. Cognitive-behavioral therapy is the preferred form of psychotherapy for GAD, although when GAD is comorbid with depression, pharmacotherapy is increasingly indicated.
Ballenger
J C
JC
Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, SC 29425-0742, USA.
Davidson
J R
JR
Lecrubier
Y
Y
Nutt
D J
DJ
Borkovec
T D
TD
Rickels
K
K
Stein
D J
DJ
Wittchen
H U
HU
D017668:Age of Onset; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D016896:Treatment Outcome
D000928:Antidepressive Agents