Psychosomatic masks of anxiety

August 9, 2019
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Anxiety disorders (AD) often interfere with somatic diseases. Physical manifestations of anxiety can mask the presence of physical illness, which makes it difficult for early diagnosis. Clinical signs of somatic disorders can be similar to somatic symptoms of anxiety, masking already severe disorders, worsening the overall course of the morbid condition and quality­ of life of the patient. For the purpose of clinical verification of healthy anxiety, anxiety and AD, appropriate classification criteria ICD-10, DSM-5 and specific testing algorithm should be used: Self-assessment scale of anxiety; The Four-Dimensional Symptom Questionnaire for the assessment of distress, depression, anxiety and somatization; Hospital anxiety and depression scale; Hamilton anxiety scale so etc. The therapy of AD following international standards is a combination of pharmacotherapy and psychotherapy, and psychotherapy of even low intensity is considered the first line of treatment. The leading methods of psychotherapy are cognitive-behavioral­ therapy and progressive relaxation, but many other psychotherapeutic approaches are practical. The standards of evidence-based medicine recommended selective serotonin reuptake inhibitors (SSRI), serotonin and norepinephrine reuptake inhibitors (SNRI) and pregabalin as the first line for psychopharmacotherapy for AD. Use pregabalin as first-line therapy in patients with intellectual disabilities, as well as in therapeutic resistance to SSRI, SNRI. Given the positive effects on sleep, somatic components of anxiety and pain syndromes pregabalin should be recommended for widespread use in patients with anxiety in general medicine. Patients with AD should not be prescribed benzodiazepines or neuroleptics if there are no specific clinical causes.

Published: 09.08.2019

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