Textbook of Anxiety Disorders

This is a large book—large in every sense of the word. More than 500 pages long, it is packed with information about a subject that, as the editors say in their preface, “has a ubiquity and a universality that extends across time and across cultures.”

It is a well-organized book. After a list of contributors and a preface, there is part 1, Approaching the Anxiety Disorders. The chapter titles are “History of Anxiety Disorders,” “Classification of Anxiety Disorders,” “Preclinical Models of Anxiety,” “Neural Circuits in Fear and Anxiety,” “Evolutionary Concepts of Anxiety,” “Cognitive Concepts of Anxiety,” “Psychodynamic Concepts of Anxiety,” and “Combined Treatment for Anxiety Disorders.”

In part 2, Generalized Anxiety Disorder, the chapter titles are “The Phenomenology of Generalized Anxiety Disorder,” “Pathogenesis of Generalized Anxiety Disorder,” “Pharmacotherapy for Generalized Anxiety Disorder,” and “Psychotherapy for Generalized Anxiety Disorder.”

Part 3, Mixed Anxiety-Depressive Disorders, has one chapter with the same title. To focus in just for a moment, this chapter includes a listing of the criteria for mixed anxiety-depressive disorders reprinted from DSM-IV-TR. A detailed discussion follows of the possible relationship between generalized anxiety and depression. The point is made that the subsyndromal mixed-symptom disorders may lead to meaningful functional impairment, a fact that most clinicians, particularly those who do disability evaluations, can readily attest to.

Part 4, Obsessive-Compulsive Disorder and Related Disorders, part 5, Panic Disorders and Agoraphobia, part 6, Social Phobias, and part 8, Posttraumatic Stress Disorder and Acute Stress Disorders, each contains four chapters—on phenomenology, pathogenesis, pharmacotherapy, and psychotherapy of the particular disorder. Part 7, Specific Phobia, reverts to a single-chapter format. Part 9, Anxiety Disorders in Special Populations, contains four chapters. These deal with anxiety in children and adolescents, in the elderly, in the context of substance abuse, and in medical settings. Part 10, Social Aspects of Anxiety Disorders, has three chapters: “Cultural and Social Aspects of Anxiety Disorders,” “Economic Costs of Anxiety Disorders,” and “Consumer Considerations.”

Finally, there is an appendix with some Internet resources, followed by a rather complete index. For those clinicians involved in the treatment of individuals with one or more anxiety disorders, the sections on pharmacotherapy in many chapters are worth the price of the book in itself. To mention just one of these, “Pharmacotherapy for PTSD,” the goals are laid out succinctly, and there is an exhaustive review of the literature covering studies using medication classes including tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs) and reversible MAOIs, selective serotonin reuptake inhibitors, antipsychotics, and others such as alprazolam and inositol. Use of these two mood stabilizers in patients with marked irritability, aggression, and explosive behavior is mentioned. Included also is a discussion of the issues in the future of pharmacotherapy that must be addressed, such as comorbidity, gender and cultural issues, and trauma severity. In the chapter on pathogenesis of panic disorder, the final paragraph deserves quoting:

To sum up, in my opinion this textbook is a highly readable, valuable contribution that puts at the reader’s fingertips just about any type of information regarding anxiety disorders, be it theoretical or practical, that one might need. This applies to clinicians, researchers, educators, and anyone else who might be interested in this subject. It is highly recommended.