Diagnosis and treatment approaches for panic disorder and social phobia

Panic and social phobia rank among the most serious anxiety disorders. However, unequivocal diagnostic criteria have not yet been defined for social phobia, so that pathological states and disordered existential orientation are nut easily identified. This creates problems especially with regard to estimates of prevalence and the choice of therapeutic strategy. Although certain pharmacological and psychotherapeutic approaches have proven to be effective, there is currently discussion about existing treatment approaches and how they can best be implemented, taking into account the severity of the disorder and comorbidity. This review gives recommendations for both types of disorder and emphasizes the encouraging outcome of treatments. When symptoms are pronounced and comorbidity exists, the combination of pharmacotherapy and psychotherapy seems to be particularly appropriate. The duration of treatment varies according to the severity of the disorder, but there is an evident need for behavior therapy and measures to prevent relapse. Patients in whom anxiety disorder becomes worse despite an improve ment of symptoms map need to be treated over several years.