ANXIETY DISORDERS ACCORDING TO DSM-IV

For a long time, anxiety disorders were categorised as forms of neurosis (see glossary), i.e., a vast set of disorders characterised by anxiety not linked to objective causes and other associated problems. These disorders began to be conceptualised through the clinical work carried out by Sigmund Freud on his own patients. The diagnostic category of the neuroses consequently ended up by being inextricably related to psychoanalytic theory. The general ‘neurosis’ category initially comprised a series of disorders that were very different from each other, the diagnostic criterion referred to being that of repressed anxiety, which it was believed was the common factor underlying all of these pathological states.

In time, various psychopathologists began to question the concept of the neuroses and felt it was no longer useful to maintain this all-inclusive category that had become so broad that it had become devoid of any true meaning from the diagnostic point of view. Starting with the DSM-III (Diagnostic and Statistical Manual of mental Disorders, Third Edition) and especially in the current DSM-IV, the old neuroses have been redistributed amongst the new, more precise diagnostic categories, which include what are now referred to as anxiety disorders.

The DSM describes six main categories: Phobias, Panic Disorder, Generalized Panic Disorder (GAD), Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder. All of these disorders are described in detail on the following pages.

It frequently occurs that a person suffering from an anxiety disorder will also present symptoms considered as characteristic of another anxiety disorder. These are cases of what is referred to as ‘comorbidity’. This depends on two factors. First of all, there is the fact that the symptoms falling into a category of disorders are not entirely specific: for example, the somatic signs of anxiety (sweating, accelerated heartbeat etc.) are common to panic disorder, Generalized Anxiety Disorder and also Post-Traumatic Stress Disorder. Secondly, current theories on the origin of the anxiety disorders are applicable to various disorders. For example, it has been proposed that the inability to control stress factors is an important aspect in the origin of both the Phobias and also Generalized Anxiety Disorder.

We can now examine the specific disorders in detail

>>> (Phobias)