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31 - Treatment of generalised anxiety and somatoform disorders

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Peter Tyrer  and
David Baldwin
Edited by
Peter Tyrer  and
Kenneth R. Silk
Peter Tyrer
Affiliation:
Imperial College London Claybrook Centre Charing Cross Campus London UK
David Baldwin
Affiliation:
Clinical Neuroscience Division University of Southampton RSH HospitalSouthampton UK
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

This subject, as indicated in the first section of this book, is a somewhat controversial one as generalised anxiety disorder has only recently achieved a level of diagnostic acceptability in the medical profession. The doubts have been expressed particularly in primary care where most of these disorders are treated. What is undoubtedly true is that generalised anxiety however, it is formulated in diagnostic terms, is extremely common and the syndrome is probably the most common seen in clinical practice. It is closely accompanied by somatoform disorders in terms of frequency so these two disorders cover most of mental illness. Common diseases usually offer hundreds of remedies and these two disorders do not disappoint this expectation. The account below indicates a good degree of consensus over general strategies of management, but the detail is all important and it is likely that a set of combined treatments at different times will be needed for these common and persistent conditions.

Generalised anxiety disorder is a persistent, common and pervasive condition of unfocused worry and anxiety, twice as common in women than men, that is not restricted to a particular setting or event, although changes in circumstances may aggravate the symptoms. Like all anxiety disorders (see Part I) it has both psychological (restlessness, irritability, sleep disturbance, feelings of threat and nervous tension) and somatic or bodily feelings (palpitations, difficulty in breathing, dizziness, nausea, dry mouth and sweating), the latter being recognised as part of the anxiety syndrome in generalised anxiety disorder but independent in the case of the somatoform disorders.

Type
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Cambridge Textbook of Effective Treatments in Psychiatry , pp. 525 - 541
Publisher: Cambridge University Press
Print publication year: 2008

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References

Akiskal, H. S. (1998). Towards a definition of GAD as an anxious temperament type. Acta Psychiatrica Scandinavica, Suppl. 393, 66–73.Google Scholar
Akiskal, H. S., Mendlowicz, M. V., Jean-Louis, G.et al. (2005). TEMPS-A: validation of a short version of a self-rated instrument designed to measure variations in temperament. Journal of Affective Disorders, 85, 45–52.Google Scholar
Allgulander, C., Hackett, D. & Salinas, E. (2001). Venlafaxine extended release (ER) in the treatment of generalised anxiety disorder. Twenty-four-week placebo-controlled dose-ranging study. British Journal of Psychiatry, 179, 15–22.Google Scholar
Allgulander, C., Florea, I. & Huusom, A. K. T. (2006). Prevention of relapse in generalized anxiety disorder by escitalopram treatment. International Journal of Neuropsychopharmacology, 9, 495–505.Google Scholar
Ashton, C. H., Rawlins, M. D. & Tyrer, S. P. (1990). A double-blind placebo-controlled study of buspirone in diazepam withdrawal in chronic benzodiazepine users. British Journal of Psychiatry, 157, 232–8.Google Scholar
Ashton, C., Whitworth, G. C., Seldomrdge, J. A.et al. (1997). Self-hypnosis reduces anxiety following coronary artery bypass surgery – a prospective, randomized trial. Journal of Cardiovascular Surgery, 38, 69–75.Google Scholar
Baldwin, D. S. (2004). Sexual dysfunction associated with antidepressant drugs. Expert Opinion on Drug Safety, 3, 457–70.Google Scholar
Baldwin, D. S. & Polkinghorn, C. (2005). Evidence-based pharmacotherapy of generalized anxiety disorder. International Journal of Neuropsychopharmacology, 8, 293–302.Google Scholar
Baldwin, D. S., Anderson, I. M., Nutt, D. J.et al. (2005). Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology, 19, 567–96.Google Scholar
Baldwin, D. S., Huusom, A. K. & Maehlum, E. (2006). Escitalopram and paroxetine in the treatment of generalised anxiety disorder: randomised, placebo-controlled, double-blind study. British Journal of Psychiatry, 189, 264–72.Google Scholar
Ballenger, J. C., Davidson, J. R. T., Lecrubier, Y.et al. (2001). Consensus statement on generalized anxiety disorder from the international consensus group on depression and anxiety. Journal of Clinical Psychiatry, 62 (suppl. 11), 53–8.Google Scholar
Bambauer, K. Z., Locke, S. E., Aupont, O., Mullan, M. G. & McLaughlin, T. J. (2005). Using the Hospital Anxiety and Depression Scale to screen for depression in cardiac patients. General Hospital Psychiatry, 27, 275–84.Google Scholar
Barlow, D. H., Rapee, R. M. & Brown, T. A. (1992). Behavioral treatment of generalized anxiety disorder. Behavior Therapy, 23, 551–70.Google Scholar
Barsky, A. J. & Ahern, D. K. (2004). Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. Journal of the American Medical Association, 291, 1464–70.Google Scholar
Bazelmans, E., Prins, J. B., Lulofs, R., Meer, J. W. M., Bleijenberg, G. & the Netherlands Fatigue Research Group Nijmegen (2005). Cognitive behaviour group therapy for chronic fatigue syndrome: a non-randomised waiting list controlled study. Psychotherapy and Psychosomatics, 74, 218–24.Google Scholar
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York: International Universities Press.
Bielski, R. J., Bose, A. & Chang, C. C. (2005). A double-blind comparison of escitalopram and paroxetine in the long-term treatment of generalized anxiety disorder. Annals of Clinical Psychiatry, 17, 65–9.Google Scholar
Bjelland, I., Dahl, A. A., Haug, T. T. & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52, 69–77.Google Scholar
Bower, P., Richards, D. & Lovell, K. (2001). The clinical and cost-effectiveness of self-help treatments for anxiety and depressive disorders in primary care: a systematic review. British Journal of General Practice, 51, 838–45.Google Scholar
Brawman-Mintzer, O., Knapp, R. G. & Nietert, P. J. (2005). Adjunctive risperidone in generalized anxiety disorder: a double-blind, placebo-controlled study. Journal of Clinical Psychiatry, 66, 1321–5.Google Scholar
Brown, J. S. L., Elliott, S. A., Boardman, J., Ferns, J. & Morrison, J. (2004). Meeting the unmet need for depression services with psycho-educational self-confidence workshops: preliminary report. British Journal of Psychiatry, 185, 511–15.Google Scholar
Butler, G., Fennell, M., Robson, P. & Gelder, M. (1991). Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 59, 167–75.Google Scholar
Casacalenda, N. & Boulenger, J. P. (1998). Pharmacologic treatments effective in both generalized anxiety disorder and major depressive disorder: clinical and theoretical implications. Canadian Journal of Psychiatry, 43, 722–30.Google Scholar
Casey, P. R., Tyrer, P. J. & Platt, S. (1985). The relationship between social functioning and psychiatric symptomatology in primary care. Social Psychiatry, 20, 5–9.Google Scholar
Chessick, C. A., Allen, H. A., Thase, M. E.et al. (2006). Cochrane Database of Systematic Reviews, 3, CD006115 2006. Oxford: Update Software.
Cormack, M. A., Sweeney, K. G., Hughes-Jones, H. & Foot, G. A. (1994). Evaluation of an easy, cost-effective strategy for cutting benzodiazepine use in general practice. British Journal of General Practice, 44, 5–8.Google Scholar
Cottraux, J., Note, I. D., Cungi, C.et al. (1995). A controlled study of cognitive behaviour therapy with buspirone or placebo in panic disorder with agoraphobia. British Journal of Psychiatry, 167, 635–41.Google Scholar
Darcis, T., Ferreri, M., Natens, J., Burtin, B., Deram, P. and the French GP Study Group for Hydroxyzine (1995). A multicenter double-blind placebo-controlled study investigating the efficacy of hydroxyzine in patients with generalized anxiety disorder. Human Psychopharmacology, 10, 181–7.Google Scholar
Deans, H. G. & Skinner, P. (1992). Doctors views on anxiety management in general practice. Journal of the Royal Society of Medicine, 85, 83–6.Google Scholar
Drent, M., Singh, S., Gorgels, A. P. M.et al. (2003). Drug-induced pneumonitis and heart failure simultaneously associated with venlafaxine. American Journal of Respiratory and Critical Care Medicine, 167, 958–61.Google Scholar
Dubicka, B., Hadley, S. & Roberts, C. (2006). Suicidal behaviour in depressed youths treated with new-generation antidepressants: meta-analysis. British Journal of Psychiatry, 189, 393–8.Google Scholar
Durham, R. C. & Allan, T. (1993). Psychological treatment of generalized anxiety disorder: a review of the clinical significance in outcome studies since 1980. British Journal of Psychiatry, 163, 19–26.Google Scholar
Durham, R. C. & Turvey, A. A. (1987). Cognitive therapy versus behaviour therapy in the treatment of chronic generalised anxiety. Behavior Research and Therapy, 25, 229–34.Google Scholar
Durham, R. C., Murphy, T., Allan, T., Richard, K., Treliving, L. R. & Fenton, G. W. (1994). Cognitive therapy, analytic psychotherapy and anxiety management training for generalized anxiety disorder. British Journal of Psychiatry, 165, 315–23.Google Scholar
Durham, R. C., Chambers, J. A., MacDonald, R. R., Power, K. G. & Major, K. (2003). Does cognitive-behavioural therapy influence the long-term outcome of generalized anxiety disorder? An 8–14 year follow-up of two clinical trials. Psychological Medicine, 33, 499–509.Google Scholar
Fawcett, J., Kravitz, G., McGuire, M.et al. (2000). Pharmacological treatments for alcoholism: revisiting lithium and considering buspirone. Alcohol Clinical and Experimental Research, 24, 666–74.Google Scholar
Fishbain, D. A., Cutler, R. B., Rosomoff, H. L. & Rosomhoff, R. S. (1998). Do antidepressants have an analgesic effect in psychogenic pain and somatoform pain disorder? A meta-analysis. Psychosomatic Medicine, 60, 503–9.Google Scholar
Flint, A. J. (2005). Generalized anxiety disorder in elderly patients: epidemiology, diagnosis and treatment options. Drugs and Aging, 22, 101–14.Google Scholar
Freud, S. (1924). On the grounds for detaching a particular syndrome from neurasthenia under the description ‘anxiety neurosis’. English translation in Complete Psychological Works, ed. Strachey, J. T., Vol. 3, pp. 85–117. London: Hogarth Press.
Freud, S. (1926). Inhibitions, symptoms and anxiety. In Complete Psychological Works, ed. Strachey, J. T., Vol. 20, pp. 75–174. London: Hogarth Press.
Goodman, W. K., Bose, A. & Wang, Q. (2000). Treatment of generalized anxiety disorder with escitalopram: pooled results from double-blind, placebo-controlled trials. Journal of Affective Disorders, 87, 161–7.Google Scholar
Gould, R. A., Otto, M. W., Pollack, M. H. & Yap, L. (1997). Cognitive behavioural and pharmacological treatment of generalised anxiety disorder: a preliminary meta-analysis. Behavior Therapy, 28, 285–305.Google Scholar
Granville-Grossman, K. L. & Turner, P. (1966). The effect of propranolol on anxiety. Lancet, i, 788–90.Google Scholar
Haddad, P. (1997). Newer antidepressants and the discontinuation syndrome. Journal of Clinical Psychiatry, 58 (Suppl 7), 17–21.Google Scholar
Hallstrom, C., Treasaden, I., Edwards, J. G. & Lader, M.(1981). Diazepam, propranolol and their combination in the management of chronic anxiety. British Journal of Psychiatry, 139, 417–21.Google Scholar
Hamilton, M. (1959). The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 50–5.Google Scholar
Hettema, J. M., Prescott, C. A. & Kendler, K. S. (2004). Genetic and environmental sources of covariation between generalized anxiety disorder and neuroticism. American Journal of Psychiatry, 161, 1581–7.Google Scholar
Holton, A. & Tyrer, P. (1990). Five year outcome of patients with-drawn from long term treatment with diazepam. Biritish Medical Journal, 300, 1241–2.Google Scholar
Jorm, A. F., Christensen, H., Griffiths, K. M., Parslow, R. A., Rodgers, B. & Blewitt, K. A. (2004). Effectiveness of complementary and self-help treatments for anxiety disorders. Medical Journal of Australia, 181(Suppl), S29–46.Google Scholar
Kahn, R. J., McNair, D. M., Lipman, R. S.et al. (1986). Imipramine and chlordiazepoxide in depressive and anxiety disorders: II. Efficacy in anxious out-patients. Archives of General Psychiatry, 43, 79–85.Google Scholar
Kapczinski, F., Schmitt, R. & Lima, M. S. (2003). The use of antidepressants for generalized anxiety disorder. Cochrane Database of Systematic Reviews, 2, CD003592. Oxford: Update Software Ltd.
Katz, I. R., Reynolds, C. F. 3rd, Alexopoulos, G. S. & Hackett, D. (2002). Venlafaxine ER as a treatment for generalized anxiety disorder in older adults: pooled analysis of five randomized placebo-controlled clinical trials. Journal of the American Geriatric Society, 50, 18–25.Google Scholar
Kellner, R., Collins, A. C., Shulman, R. S. & Pathak, D. (1974). The short-term antianxiety effects of propranolol HCl (1974). Journal of Clinical Pharmacology, 14, 301–4.Google Scholar
Klein, D. F. (1967). Importance of psychiatric diagnosis in prediction of clinical drug effects. Archives of General Psychiatry, 16, 118–25.Google Scholar
Kool, S., Dekker, J., Duijsens, I. J., Jonghe, F. & Puite, B. (2003). Efficacy of combined therapy and pharmacotherapy for depressed patients with or without personality disorders. Harvard Review of Psychiatry, 11, 133–41.Google Scholar
Kroenke, K. & Swindle, J. (2000). Cognitive-behavioral therapy for somatization and symptom syndromes: a critical review of controlled clinical trials. Psychotherapy and Psychosomatics, 69, 205–15.Google Scholar
Kroenke, K., Messina, N. 3rd, Benattia, I., Graepel, J. & Musgnung, J. (2006). Venlafaxine extended release in the short-term treatment of depressed and anxious primary care patients with multisomatoform disorder. Journal of Clinical Psychiatry, 67, 72–80.Google Scholar
Lader, M. H. & Bond, A. J. (1998). Interaction of pharmacological and psychological treatments of anxiety. British Journal of Psychiatry, Suppl. 34, 42–48.Google Scholar
Larkin, B. A., Copeland, J. R. M., Dewey, M. E.et al. (1992). The natural history of neurotic disorder in an elderly urban population: findings from the Liverpool study of continuing health in the community. British Journal of Psychiatry, 160, 681–6.Google Scholar
Lawrenson, R. A., Tyrer, F., Newson, R. B. & Farmer, R. D. (2000). The treatment of depression in UK general practice: selective serotonin reuptake inhibitors and tricyclic antidepressants compared. Journal of Affective Disorders, 59, 149–57.Google Scholar
Layard, R. (2006). The case for psychological treatment centres. British Medical Journal, 332, 1030–2.Google Scholar
Lipowski, Z. J. (1988). Somatization: the concept and its clinical application. American Journal of Psychiatry, 145(11), 1358–68.Google Scholar
Llorca, P. M., Sapdine, C., Sol, O.et al. (2002). Efficacy and safety of hydroxyzine in the treatment of generalized anxiety disorder: a three-month double-blind study. Journal of Clinical Psychiatry, 63, 1020–7.Google Scholar
Mann, A. H., Jenkins, R. & Belsey, E. (1981). The twelve-month outcome of patients with neurotic illness in general practice. Psychological Medicine, 11, 535–50.Google Scholar
Marks, I. M., Mataix-Cols, D., Kenwright, M., Cameron, R., Hirsch, S. & Gega, L. (2003). Pragmatic evaluation of computer-aided self-help for anxiety and depression. British Journal of Psychiatry, 183, 57–65.Google Scholar
McCrone, P., Knapp, M., Proudfoot, J.et al. (2004). Cost-effectiveness of computerized cognitive behaviour therapy for anxiety and depression in primary care: randomized controlled trial. British Journal of Psychiatry, 185, 55–62.Google Scholar
Meibach, R. C., Dunner, D. M., Wilson, L. G., Ishiki, D. & Dager, S. R. (2001). Comparative efficacy of propranolol, chlordiazepoxide, and placebo in the treatment of anxiety: a double-blind trial. Journal of Clinical Psychiatry, 62, 523–39.Google Scholar
Mendels, J., Krajewski, T. F., Huffer, V.et al. (1986). Effective short-term treatment of generalised anxiety with trifluoperazine. Journal of Clinical Psychiatry, 47, 170–4.Google Scholar
Meyer, T. J., Miller, M. L., Metzger, R. L. & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behavior Research and Therapy, 28, 487–95.Google Scholar
Mitchell, A. J. (2006). Two-week delay in onset of action of antidepressants: new evidence. British Journal of Psychiatry, 188, 105–6.Google Scholar
Mitte, K., Noack, P., Steil, R. & Hautzinger, M. (2005). A meta-analytic review of the efficacy of drug treatment in generalized anxiety disorder. Journal of Clinical Psychopharmacology, 25, 141–50.Google Scholar
Montgomery, S. A., Sheehan, D. V., Meoni, P., Haudiquet, V. & Hackett, D. (2002a). Characterization of the longitudinal course of improvement during long term treatment with venlafaxine XR. Journal of Psychiatric Research, 36, 209–17.Google Scholar
Montgomery, S. A., Mahe, V., Haudiquet, V. & Hackett, D. (2002b). Effectiveness of venlafaxine, extended release formulation, in short-term and long-term treatment of generalized anxiety disorder: results of a survival analysis. Journal of Clinical Psychopharmacology, 21, 561–7.Google Scholar
Morley, S., Eccleston, C. & Williams, A. (1999). Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain, 80, 1–13.Google Scholar
Muller, T., Mannel, M., Murck, H. & Rahlfs, V. W. (2004). Treatment of somatoform disorders with St. John's wort: a randomized, double-blind and placebo-controlled trial (2004). Psychosomatic Medicine, 66, 538–47.Google Scholar
Murphy, S. M., Owen, R. & Tyrer, P. (1989). Comparative assessment of efficacy and withdrawal symptoms after 6 and 12 weeks' treatment with diazepam or buspirone. British Journal of Psychiatry, 154, 529–34.Google Scholar
National Institute for Clinical Excellence (NICE)(2002). Guidance on the use of computerised cognitive behavioural therapy for anxiety and depression. Health Technology Appraisal Guidance 51. London: NICE.
National Institute for Clinical Excellence (NICE)(2004). The management of panic disorder and generalised anxiety disorder in primary and secondary care. London: National Collaborating Centre for Mental Health.
Newman, M. G., Zuellig, A. R., Kachin, K. E.et al. (2002). Preliminary reliability and validity of the Generalized Anxiety Disorder Questionnaire IV: a revised self-report diagnostic measure of generalized anxiety disorder. Behavior Therapy, 28, 215–33.Google Scholar
Nutt, D. J. (2005). Death by tricyclic: the real antidepressant scandal? Journal of Psychopharmacology, 19, 123–4.Google Scholar
Onghena, P., Cuyper, H., Houdenhove, B. & Verstraeten, D. (1993). Mianserin and chronic pain: a double-blind placebo-controlled process and outcome study. Acta Psychiatrica Scandinavica, 88, 198–204.Google Scholar
Oude Voshaar, R. C., Couvée, J. E., Balkom, A. J. L. M., Mulder, P. G. H. & Zitman, F. G. (2006). Strategies for discontinuing long-term benzodiazepine use: meta-analysis. British Journal of Psychiatry, 189, 213–20.Google Scholar
Paykel, E. S. & Priest, R. G. (1992). Recognition and management of depression in general practice: consensus statement. British Medical Journal, 305, 1198–202.Google Scholar
Piercy, M. A., Sramek, J. J., Kurtz, N. M. & Cutler, N. R. (1996). Placebo response in anxiety disorders. Annals of Pharmacotherapy, 30, 1013–19.Google Scholar
Pilowsky, I. (1969). Abnormal illness behaviour. British Journal of Medical Psychology, 42, 347–51.Google Scholar
Pollack, M. H., Simon, N. M., Zalta, A. K.et al. (2006). Olanzapine augmentation of fluoxetine for refractory generalized anxiety disorder: a placebo-controlled study. Biological Psychiatry, 59, 211–15.Google Scholar
Power, K. G., Simpson, R. J., Swanson, V. & Wallace, L. A. (1990). Controlled comparison of pharmacological and psychological treatment of generalized anxiety disorder in primary care. British Journal of General Practice, 40, 289–94.Google Scholar
Priest, R. G. & Montgomery, S. A. (1988). Benzodiazepines and dependence: a College statement. Psychiatric Bulletin, 12, 107–8.Google Scholar
Proudfoot, J., Ryden, C., Everitt, B.et al. (2004). Clinical effectiveness of computerized cognitive behaviour therapy for anxiety and depression in primary care. British Journal of Psychiatry, 185, 46–54.Google Scholar
Regier, D. A., Narrow, W. E. & Rae, D. S. (1990). The epidemiology of anxiety disorders: the Epidemiologic Catchment Area (ECA) experience. Journal of Psychiatric Research, 24 (Suppl. 2), 3–14.Google Scholar
Rickels, K., Schweizer, E., Csanalosi, I., Case, W. G. & Chung, H. (1988). Long-term treatment of anxiety and risk of withdrawal: prospective study of clorazepate and buspirone. Archives of General Psychiatry, 45, 444–50.Google Scholar
Romach, M., Busto, U., Somer, G., Kaplan, H. l. & Sellers, E. (1995). Clinical aspects of chronic use of alprazolam and lorazepam. American Journal of Psychiatry, 152, 1161–7.Google Scholar
Ruhé, H. G., Huyser, J., Swinkels, J. A. & Schene, A. H. (2006). Dose escalation for insufficient response to standard-dose selective serotonin reuptake inhibitors in major depressive disorder: systematic review. British Journal of Psychiatry, 189, 309–16.Google Scholar
Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C. & Clark, D. M. (2002). The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hpochondriasis. Psychological Medicine, 32, 843–53.Google Scholar
Salzman, C., Goldenberg, I., Bruce, S. E. & Keller, M. B. (2001). Pharmacologic treatment of anxiety disorders in 1989 versus 1996: Results from the Harvard/Brown anxiety disorders research program. Journal of Clinical Psychiatry, 62, 149–52.Google Scholar
Schatzberg, A. F., Blier, P., Delgado, P. L., Fava, M., Haddad, P. M. & Shelton, R. C. (2006). Antidepressant discontinuation syndrome: consensus panel recommendations for clinical management and additional research. Journal of Clinical Psychiatry, 67 (Suppl. 4), 27–30.Google Scholar
Seivewright, H. & Tyrer, P. (2005). Schedule for Evaluating Persistent Symptoms (SEPS). London: Imperial College, Department of Psychological Medicine.
Seivewright, H., Tyrer, P., Casey, P. & Seivewright, N. (1991). A three-year follow-up of psychiatric morbidity in urban and rural primary care. Psychological Medicine, 21, 495–503.Google Scholar
Seivewright, H., Tyrer, P. & Johnson, T. (1998). Prediction of outcome in neurotic disorder: a five year prospective study. Psychological Medicine, 28, 1149–57.Google Scholar
Seivewright, H., Tyrer, P. & Johnson, T. (2002). Change in personality status in neurotic disorders. Lancet, 359, 2253–4.Google Scholar
Seivewright, H., Green, J., Salkovskis, P., Barrett, B., Nur, U. & Tyrer, P. (2007). Randomised controlled trial of cognitive behaviour therapy in the treatment of health anxiety in a genito-urinary medicine clinic. (in press)
Severens, J. L., Prins, J. B., Wilt, G. J., Meer, J. W. M. & Bleijenberg, G. (2004). Cost-effectiveness of cognitive behaviour therapy for patients with chronic fatigue syndrome. QJM: An International Journal of Medicine, 97, 153–61.Google Scholar
Sheehan, D. V., Ballenger, J. & Jacobsen, G. (1980). Treatment of endogenous anxiety with phobic, hysterical, and hypochondriacal symptoms. Archives of General Psychiatry, 37, 51–9.Google Scholar
Stahl, S. M., Gergel, I. & Li, D. (2003). Escitalopram in the treatment of panic disorder: a randomized, double-blind, placebo-controlled trial. Journal of Clinical Psychiatry, 64, 1322–7.Google Scholar
Stocchi, F. G., Nordera, G., Jokinen, R. H.et al. (2003). Efficacy and tolerability of paroxetine for the long-term treatment of generalized anxiety disorder. Journal of Clinical Psychiatry, 64, 250–8.Google Scholar
Stulemeijer, M., Jong, L. W. A. M., Fiselier, T. J. W., Hoogveld, S. W. B. & Bleijenberg, G. (2005). Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial. British Medical Journal, 330, 14–17.Google Scholar
Taylor, F. K. (1989). The damnation of benzodiazepines. British Journal of Psychiatry, 154, 353–60.Google Scholar
Thase, M. E., Entsuah, A. R. & Rudolph, R. L. (2001). Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors. British Journal of Psychiatry, 178, 234–41.Google Scholar
Turkington, D., Grant, J. B., Ferrier, I. N., Rao, N. S., Linsley, K. R. & Young, A. H. (2002). A randomized controlled trial of fluvoxamine in prostatodynia, a male somatoform pain disorder. Journal of Clinical Psychiatry, 63, 778–81.Google Scholar
Tyrer, P. (1973). Relevance of bodily feelings in emotion. Lancet, i, 915–16.Google Scholar
Tyrer, P. (1992). Anxiolytics not acting at the benzodiazepine receptor: beta-blockers. Progress in Neuropsychopharmacology and Biological Psychiatry, 16, 17–26.Google Scholar
Tyrer, P. & Baldwin, D. (2006). Generalized anxiety disorder. Lancet, 368, 2156–66.Google Scholar
Tyrer, P. & Lader, M. H. (1974). Response to propranolol and diazepam in somatic and psychic anxiety. British Medical Journal, 2, 14–16.Google Scholar
Tyrer, P. & Owen, R. (1984). Anxiety in primary care: is short-term drug treatment appropriate? Journal of Psychiatric Research, 18, 73–8.Google Scholar
Tyrer, P., Rutherford, D. & Huggett, T. (1981). Benzodiazepine withdrawal symptoms and propranolol. Lancet, i, 520–2.Google Scholar
Tyrer, P., Owen, R. & Dawling, S. (1983). Gradual withdrawal of diazepam after long-term therapy. Lancet, i, 1402–6.Google Scholar
Tyrer, P., Seivewright, N., Murphy, S.et al. (1988). The Nottingham study of neurotic disorder: comparison of drug and psychological treatments. Lancet, ii, 235–40.Google Scholar
Tyrer, P., Seivewright, N., Ferguson, B., Murphy, S. & Johnson, A. L. (1993). The Nottingham study of neurotic disorder: impact of personality status on response to drug treatment, cognitive therapy and self-help over two years. British Journal of Psychiatry, 162, 219–26.Google Scholar
Boeijen, C. A., Balkom, A. J., Oppen, P., Blankenstein, N., Cherpanath, A. & Dyck, R. (2005). Efficacy of self-help manuals for anxiety disorders in primary care: a review. Family Practice, 22, 192–6.Google Scholar
Versiani, M., Nardi, A. E., Mundim, F. D., Alves, A. B., Liebowitz, M. R. & Amrein, R. (1992). Pharmacotherapy of social phobia. A controlled study with moclobemide and phenelzine. British Journal of Psychiatry, 161, 353–60.Google Scholar
Volz, H. P., Murck, H., Kasper, S. & Moller, H. J. (2002). St John's wort extract (LI 160) in somatoform disorders: results of a placebo-controlled trial. Psychopharmacology, 164, 294–300.Google Scholar
Volz, H. P., Moller, H. J., Reimann, I. & Stoll, K. D. (2000). Opipramol for the treatment of somatoform disorders. Results from a placebo-controlled trial. European Neuropsychopharmacology, 10, 211–17.Google Scholar
Whittington, C. J., Kendall, T., Fonagy, P., Cottrell, D., Cotgrove, A. & Boddington, E. (2004). Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. Lancet, 363, 1341–5.Google Scholar
Zigmond, A. S. & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 57, 361–70.Google Scholar
Zonderman, A. B., Heft, M. W. & Costa, P. T. (1985). Does the Illness Behavior Questionnaire measure abnormal illness behaviour?Health Psychology, 4, 425–36.Google Scholar

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Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

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