Anxiety disorders affect more than 40 million adults in the United States, or approximately 18% of the population1. Most of the treatment of anxiety disorders is prescribed by family doctors and internists. Untreated anxiety disorders lead to a great deal of unnecessary stress, fear, and uncertainty among a large number of patients and their families. Anxiety disorders encompass a number of different syndromes, including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, adjustment disorders, posttraumatic stress disorder, social anxiety disorder, and specific phobias.

In the primary care physicians office, anxiety often manifests as patients present with multiple somatic symptoms, and it takes a high level of suspicion, skill, kindness, and finesse to identify and address anxiety when patients are not aware that their symptoms stem from anxiety. Less often, patients come into the office seeking treatment with specific concerns about anxiety. In a recent survey, one-third of family physicians indicated a high degree of need for more continuing medical education about anxiety disorders and 78% indicated that they have a moderate or high need for continuing education about anxiety.

Anxiety Disorders, by Drs. John R. Vanin and James D. Helsley, fills an important void as a concise yet complete overview for primary care physicians of the most current thinking on the diagnosis and treatment of anxiety. The chapters are intelligently written with an emphasis on clinically relevant, evidence-based information that is useful in the treatment of our patients. There are chapters on psychopharmacology, psychotherapy, and each of the major anxiety disorders. Each chapter reviews the evidence supporting best practices in the treatment of each anxiety disorder so that the reader understands the full range of options available for effective care. It is a book that deserves to be on the shelf of all primary care physicians.

As a practicing psychiatrist for nearly thirty years, I have known and worked with primary care practitioners who recognize and treat patients with mental disorders as well as any psychiatrist. I have also known primary care practitioners who have little interest in psychiatric issues as well as those who have considerable difficulty conceptualizing, much less verbalizing, treatment options for patients with these disorders. This is not meant to be a criticism. Practitioners who are not interested in mental health issues often have such a diverse and heavy general medical patient demand that excluding psychiatric disorders seems to be the least harmful option.

The ultimate goal of medical practice is to relieve suffering and make our diagnostic skills and treatment options the best available for our patients. This pocket guide is a tremendous addition for those who are interested in increasing their knowledge of mental health, particularly the recognition, diagnosis, and treatment of anxiety disorders. The details will expand the primary care practitioner’s fund of knowledge and level of comfort regarding this large, yet elusive and complicated, segment of primary care. The material is thought provoking for practitioners who have had little or no experience in diagnosing and treating common anxiety disorders as well as for practitioners who are seasoned and regularly treat anxiety disorders and want to expand their knowledge base.

The quality of patient care will increase exponentially for clinicians who absorb the information that this book provides. This pocket guide is a real treat and long overdue!

According to the National Comorbidity Survey Replication, the 12-month prevalence of adults in the United States with any mental disorder seen by a general medical professional is greater than 22% [1]. The level of disability among primary care patients with mental disorders is higher than many practitioners suspect, and can be greater than the disabilities from chronic general medical conditions such as hypertension, diabetes, arthritis, and back pain [2]. Anxiety disorders affect over one fourth of U.S. adults at some point during their lifetime [3]. In any 12-month period, nearly one fourth of patients with anxiety disorders are treated by a general medical professional [1], and these patients account for at least 10% of primary care visits [4].