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Anxiety Disorders

Anxiety disorders are the most common mental disorders among adults with a peak in incidence during young adulthood. Anxiety disorders are associated with high rates of psychiatric comorbidity, physical illness, social and occupational disability, suicidality, and high rates of health service utilization in the United States and worldwide. There are mounting data to suggest that anxiety disorders begin early in life, are common among youth and adults, frequently persist throughout development, and increase the risk of subsequent psychosocial and psychiatric morbidity, including suicidal behavior, from early childhood into adulthood. Moreover, despite rapid increases in availability of efficacious psychotherapeutic and psychopharmacologic treatments for anxiety disorders in the past three decades, evidence to date suggests that few with anxiety disorders seek and receive treatment.
The prevalence of anxiety disorders has been documented in a number of cross-sectional psychiatric epidemiologic studies that suggest that the lifetime prevalence of anxiety disorders ranges from 24.9% to 44% among adults in the community.

Risk Factors

In recent years, there has been increasing interest into factors that influence an individual's risk of developing an anxiety disorder. In contrast to heavy research investment into a number of other mental disorders, including conduct, mood, and psychotic disorders, there has been comparatively little research into the risk factors for anxiety disorders. Available evidence to date suggests that demographic factors, a history of childhood physical or sexual abuse, family history of anxiety disorders, disruption in parenting, and certain perinatal factors may increase the risk of anxiety disorders. In addition, individual factors associated with risk of anxiety disorders include evidence of mental disorders in childhood and certain genetic and personality factors.
Numerous studies have documented an association between specific demographic factors and increased risk of anxiety disorders. These studies variously show that factors such as female gender, lower socioeconomic status, minority racial status, marital status, and age are associated with increased risk of anxiety disorders in adulthood.
Childhood physical abuse has been associated in numerous studies with increased risk of mental disorders, though there is notably less research investigating these linkages compared with the impact of sexual abuse on later mental health. These studies variously show that exposure to childhood sexual abuse, especially severe abuse, is related to a significantly increased risk of a wide range of mental disorders, including anxiety disorders, in adulthood. Recent studies have shown linkages between childhood abuse and increased rates of panic disorder, panic attacks, social phobia, specific phobia, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) among youth and adults. In sum, the evidence to date suggests a link between exposure to childhood physical abuse and increased risk of anxiety disorders.
Several studies have documented an association between childhood sexual abuse and increased risk of anxiety disorders. These studies variously show that exposure to childhood sexual abuse, especially contact sexual abuse, is related to a significantly increased risk of anxiety and anxiety disorders in adulthood. In a recent review of this literature, Fergusson and Mullen identified more than 30 studies that found that children known to have been sexually abused

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