The impact of anxiety disorders is sky-high, but it can be reduced
The biggest challenge of anxiety disorders is their persistence. Current approaches fail to adequately address this, focusing too much on short-term solutions. However, the emphasis should be on the long term. According to Neeltje Batelaan, professor of psychiatry and anxiety-related disorders at Amsterdam UMC, in her inaugural lecture on the 5th of September.
Recent figures show a concerning trend: the percentage of adults in the Netherlands with anxiety disorders has risen from 10% to 15%. The societal impact is enourmous, as recently reported by the RIVM. “The impact must be reduced,” Batelaan emphasizes. People are unable to go to the supermarket or go to work. They become isolated, and their partners take over tasks. Employers face high absenteeism. Children unintentionally learn anxious behaviors.
Better alignment with the nature of the disorder
Initially, anxiety disorders are often mild, but over time they can become more persistent. Avoidance behaviors and co-occurring conditions like depression or substance abuse emerge, worsening the prognosis. Current treatments do not offer lasting solutions. One in four people experience a relapse after successful cognitive behavioral therapy, and one in three relapse after discontinuation of medication. Interventions to prevent relapse are not yet a standard part of treatment, simply because research on this is lacking.
To improve the prognosis of anxiety disorders, Batelaan advocates for an approach that better aligns with the specific characteristics of the disorder. Since more than half of anxiety disorders develop before the age of 18, vigilance during youth and adolescence is important. Persistence must be prevented with early intervention and timely care. Batelaan’s vision is supported by data from a recent societal cost-benefit analysis. In her view, waiting until the issue becomes severe is unwise, but this is often the current reality. Increased knowledge in society and among healthcare professionals is essential to change this. Additionally, reducing waiting times in mental healthcare is crucial.
Batelaan also calls for the development of follow-up treatments, as one-third to half of patients do not fully recover after initial treatment. The near absence of such treatments has also been noted in the revised multidisciplinary treatment guidelines for anxiety and obsessive-compulsive disorders (in Dutch), which is published this week.
