title: Anxiety disorders and comorbid medical illness.
abstract: OBJECTIVE
  To provide an overview of the role of anxiety disorders in medical illness.
  
  
  METHODS
  The Anxiety Disorders Association of America held a multidisciplinary conference from which conference leaders and speakers reviewed presentations and discussions, considered literature on prevalence, comorbidity, etiology and treatment, and made recommendations for research. Irritable bowel syndrome (IBS), asthma, cardiovascular disease (CVD), cancer and chronic pain were reviewed.
  
  
  RESULTS
  A substantial literature supports clinically important associations between psychiatric illness and chronic medical conditions. Most research focuses on depression, finding that depression can adversely affect self-care and increase the risk of incident medical illness, complications and mortality. Anxiety disorders are less well studied, but robust epidemiological and clinical evidence shows that anxiety disorders play an equally important role. Biological theories of the interactions between anxiety and IBS, CVD and chronic pain are presented. Available data suggest that anxiety disorders in medically ill patients should not be ignored and could be considered conjointly with depression when developing strategies for screening and intervention, particularly in primary care.
  
  
  CONCLUSIONS
  Emerging data offer a strong argument for the role of anxiety in medical illness and suggest that anxiety disorders rival depression in terms of risk, comorbidity and outcome. Research programs designed to advance our understanding of the impact of anxiety disorders on medical illness are needed to develop evidence-based approaches to improving patient care.
authors.affiliation: University of Washington School of Medicine, Seattle, WA 98195, USA. roybyrne@u.washington.edu
authors.forename: Peter P
authors.initials: PP
authors.lastname: Roy-Byrne
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.forename: Gordon J G
authors.initials: GJ
authors.lastname: Asmundson
authors.forename: Renee D
authors.initials: RD
authors.lastname: Goodwin
authors.forename: Laura
authors.initials: L
authors.lastname: Kubzansky
authors.forename: R Bruce
authors.initials: RB
authors.lastname: Lydiard
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Massie
authors.forename: Wayne
authors.initials: W
authors.lastname: Katon
authors.forename: Sally K
authors.initials: SK
authors.lastname: Laden
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
mesh_terms: D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D059408:Pain Management; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D014151:Anti-Anxiety Agents; D017367:Selective Serotonin Reuptake Inhibitors