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Anxiety Disorders: Theory, Research and Clinical Perspectives

James Allen Wilcox, DO, PhD

University of Arizona,Tucson, AZ, USA

Edited by Helen Blair Simpson, Yuval Neria, Roberto Lewis-Fernández, and Franklin Schneier. New York, NY: Cambridge University Press; 2010; ISBN: 978-0-521-51557-3; pp 378; $99 (hardcover).

It is uncommon to read a good book on anxiety disorders. This one, however, is unusually fine. Anxiety Disorders: Theory, Research and Clinical Perspectives is highly descriptive and clinically useful. It is well researched and a pleasure to read.

Anxiety often is overlooked in modern clinical practice. Although it is no longer considered the basis of all psychological problems by way of ambivalence or neurotic conflict, anxiety is very important in clinical practice. We see many of the issues noted in this book in our clinics daily. Patients often respond to stress with anxiety. Many cases of agitated depression are fraught with tension and worry. Panic attacks cause our patients to seek emergency treatment due to the extremely unpleasant nature of physiology exerted by anxiety. This unpleasant feeling also pushes many people with anxiety into addiction to a variety of drugs, from ethanol to benzodiazepines. Anxiety is a powerful motivator, and it must be respected.

The editors of this text have done a wonderful job of assembling material. The contributing authors are a well-known group of opinion leaders that come from both clinical and research settings. The book contains 31 sections, each like a short chapter. Each portion is concise and devoted to a unique problem in the anxiety field. This volume begins with an excellent review of the epidemiology and nosology of anxiety disorders. There is a meaningful discussion on the evolution of anxiety from a symptom to a syndrome of disorders. As the book goes on, the variety of anxiety-related problems are illustrated, from obsessive-compulsive disorder to posttraumatic stress disorder, social anxiety, and panic attacks. Each topic is well handled and both symptoms and treatment options are covered in fine detail.

Several sections discussing the physiology of anxiety are included. This goes from basic cellular material to primate models and on to genetic theories. This discussion of basic biological modulation is brought to life in later sections on treatment using various somatic therapies. There is a good description of using selective serotonin reuptake inhibitors, atypical antipsychotics, and benzodiazepines. The use of behavioral therapies also is discussed. These sections contain interesting diagrams, which augment the instructional impact of the text.

Anxiety in childhood, attachment disorders, and evidence-based treatment all are included in the later sections of the book. There are also sections about alternative medical treatment and best practices for dealing with anxiety in primary care. The clinical material is interesting and provides for far better reading than most people would expect from any medical book. It is written in a compelling style, which is a benefit to the student, clinician, or educated layman. The references are excellent and the index is helpful.

This is a good book for any clinician interested in anxiety. It covers theory, diagnoses, treatment, and future directions. It is enjoyable to read it and a good book to keep in the office. I highly recommend it.