The spectrum of generalised anxiety in clinical practice: the role of short-term, intermittent treatment∗

Abstract

Background DSM–IV generalised anxiety disorder (GAD) has a high lifetime prevalence, but subthreshold anxiety states are even more common, particularly in family practice.Method Generalised anxiety is conceptualised as a spectrum of disorders, with transient anxiety at one end and GAD at the other.Results Based on longterm experience with family practice patients, the authors suggest that most anxious patients, wherever on this continuum they are placed, could be treated with short-term, possibly intermittent, rather than chronic anxiolytic therapy. Data are presented which show that 50% of chronic GAD patients are only in need of such short-term intermittent therapy.Conclusions Further clinical research is needed to refine short-term, intermittent treatments for anxiety spectrum disorders, to make effective treatments available to those suffering from anxiety but falling short of diagnostic criteria for GAD, and to target more effectively the different treatment strategies.