In the current issue of the Lancet, Brenda Penninx published a state-of-the-art piece on Anxiety Disorders. She wrote this paper together with three international colleagues: Daniel Pine, Emily Holmes and Andreas Reif. 

As they illustrate in their paper, anxiety disorders form the most common group of mental disorders and generally start before or in early adulthood. Core features include excessive fear, anxiety and/or avoidance of perceived threats that are persistent and impairing. Anxiety disorders involve dysfunction in brain circuits that respond to danger. Risk for anxiety disorders is influenced by genetic factors, environmental factors, and their epigenetic relations. Anxiety disorders are often comorbid with one another and with other mental disorders, especially depression, as well as with somatic disorders. Such comorbidity generally signifies higher severity, greater clinical burden, and greater treatment difficulty. Reducing the large individual and global burden of disease from anxiety disorders can be best achieved by timely, accurate disease detection and adequate treatment administration, scaling up of treatments when needed. Evidence-based psychotherapy, particularly cognitive behavioural therapy, and psychoactive medications, particularly serotonergic compounds, are both effective, facilitating patients’ choices in therapeutic decisions. While promising, no enduring preventive measures exist yet, and, along with frequent therapy resistance, this creates unaddressed clinical needs. Current research efforts tackle these problems, and future efforts should seek individualized, more effective, precision-medicine treatment approaches.