Anxiety Disorder

Generalized Anxiety Disorder 7-item (GAD-7) and 2-item (GAD-2) scales for detecting anxiety disorders in adults.

Aktürk Z, Hapfelmeier A, Fomenko A, Dümmler D, Eck S, Olm M · The Cochrane database of systematic reviews · 2025 · n=228

Anxiety disorders often remain undetected and can cause substantial burden. Amongst the many anxiety screening tools, the 7-item Generalized Anxiety Disorder (GAD-7) scale and its short version, the 2-item Generalized Anxiety Disorder (GAD-2) scale, are the most frequently used instruments. Primary: to determine the diagnostic accuracy of GAD-7 and GAD-2 to detect generalised anxiety disorder (GAD) and any anxiety disorder (AAD) in adults. Secondary: to investigate whether their diagnostic accuracy varies by setting, anxiety disorder prevalence, reference standard, and risk of bias; to compare the diagnostic accuracy of GAD-7 and GAD-2; to investigate how diagnostic performance changes with the test threshold. We searched MEDLINE, Embase, PubMed-not-MEDLINE subset, and PsycINFO from 1990 to 18 January 2024. We checked reference lists of included studies and review articles. We included cross-sectional studies conducted in adults, containing diagnostic accuracy information on GAD-7 a

CBT treatment delivery formats for generalized anxiety disorder: a systematic review and network meta-analysis of randomized controlled trials.

Liu S, Xiao H, Duan Y, Shi L, Wang P, Cao L · Translational psychiatry · 2025 · n=4361

To assess the comparative efficacy and acceptability of different delivery formats of cognitive behavior therapy (CBT) in treating generalized anxiety disorder (GAD). We searched MEDLINE, Embase, PsycINFO, and the Web of Science from database inception to September, 2023, to identify randomized clinical trials (RCTs) of CBT for patients with GAD. Pairwise and network meta-analyses were conducted using a random-effects model. Finally, 52 trials that randomized 4361 patients (mean age 43 years; 69.7% women) with generalized anxiety disorder met the inclusion criteria. The most studied treatment comparisons were individual and remote CBT versus waiting list. The quality of the evidence was typically of low or unclear risk of bias (39 out of 52 trials, 75%). The network meta-analysis including 30 studies showed that individual CBT was superior to remote CBT (SMD 0.96; 95% Cl 0.13-1.79), treatment as usual (SMD 1.12; 95% Cl 0.24-2.00) and waiting list (SMD 1.62; 95% Cl 1.03-2.22) in relie

Antidepressants versus placebo for generalised anxiety disorder (GAD).

Kopcalic K, Arcaro J, Pinto A, Ali S, Barbui C, Curatoli C · The Cochrane database of systematic reviews · 2025 · n=226

Generalised anxiety disorder (GAD) is a mental health condition characterised by excessive anxiety and worry about everyday events. GAD is a common disorder and generally affects women twice as often as men. Treatments include various psychological and pharmacological therapies. Among the pharmacological therapies, antidepressants, in particular, selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs), are commonly used for the treatment of GAD and many studies have shown their benefit over placebo. Only one systematic review and meta-analysis comparing all antidepressants to placebo has been done in the past. Since then, new data on existing antidepressants have emerged and new antidepressants have been introduced. An updated and more comprehensive review is needed to provide a stronger understanding of the efficacy, acceptability, tolerability, and impact on the quality of life of the various types of antidepressants compared to placebo

Digital health interventions for mental health disorders: an umbrella review of meta-analyses of randomised controlled trials.

Crocamo C, Palpella D, Cavaleri D, Nasti C, Piacenti S, Morello P · The Lancet. Digital health · 2025

Digital health interventions (DHIs) show promise for the treatment of mental health disorders. However, existing meta-analytical research is methodologically heterogeneous, with studies including a mix of clinical, non-clinical, and transdiagnostic populations, hindering a comprehensive understanding of DHI effectiveness. Thus, we conducted an umbrella review of meta-analyses of randomised controlled trials investigating the effectiveness of DHIs for specific mental health disorders and evaluating the quality of evidence. We searched three public electronic databases from inception to February, 2024 and included 16 studies. DHIs were effective compared with active interventions for schizophrenia spectrum disorders, major depressive disorder, social anxiety disorder, and panic disorder. Notable treatment effects compared with a waiting list were also observed for specific phobias, generalised anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and bulimia ne

Probiotic, prebiotic, synbiotic and fermented food supplementation in psychiatric disorders: A systematic review of clinical trials.

Ribera C, Sánchez-Ortí JV, Clarke G, Marx W, Mörkl S, Balanzá-Martínez V · Neuroscience and biobehavioral reviews · 2024

The use of probiotics, prebiotics, synbiotics or fermented foods can modulate the gut-brain axis and constitute a potentially therapeutic intervention in psychiatric disorders. This systematic review aims to identify current evidence regarding these interventions in the treatment of patients with DSM/ICD psychiatric diagnoses. Forty-seven articles from 42 studies met the inclusion criteria. Risk of bias was assessed in all included studies. Major depression was the most studied disorder (n = 19 studies). Studies frequently focused on schizophrenia (n = 11) and bipolar disorder (n = 5) and there were limited studies in anorexia nervosa (n = 4), ADHD (n = 3), Tourette (n = 1), insomnia (n = 1), PTSD (n = 1) and generalized anxiety disorder (n = 1). Except in MDD, current evidence does not clarify the role of probiotics and prebiotics in the treatment of mental illness. Several studies point to an im

The effects of L-theanine supplementation on the outcomes of patients with mental disorders: a systematic review.

Moshfeghinia R, Sanaei E, Mostafavi S, Assadian K, Sanaei A, Ayano G · BMC psychiatry · 2024

When utilized as an adjunct with antidepressants, antipsychotics, and other psychopharmacological drugs, certain amino acids, such as L-Theanine (LT), have shown potential effectiveness in enhancing the symptomatic outcomes of patients with mental disorders. Despite this, there is a lack of previous systematic reviews examining these associations. Therefore, we conducted a systematic review of randomized controlled trials examining these relationships. A comprehensive systematic review was conducted, scouring six electronic databases (PubMed, Scopus, PsycINFO, Web of Science, CINAHL Complete, and Cochrane) from their inception up to June 2023, specifically focusing on randomized controlled trials that investigated the effects of LT supplementation on the outcomes of patients with mental health disorders. The Cochrane Risk of Bias Tool for Randomized Trials was employed to assess the quality of the included studies. Among the 419 publications identified, 11 studies from six countries

Brazilian Psychiatric Association guidelines for the treatment of social anxiety disorder.

Baldaçara L, Almeida TM, Dos Santos DC, Paschoal AB, Pinto AF, Gaiotto LAV · Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) · 2025

Social anxiety disorder (SAD), one of the most prevalent anxiety disorders, is not well recognized. In most cases, SAD follows an unremitted and chronic course, affecting individual functioning in relationships, education, and work. Due to the disorder's relevance in Brazil, guideline-based treatments adapted to the Brazilian social and economic context are needed. We conducted a systematic review assessing several treatment modalities for SAD. PubMed, Cochrane, SciELO, and ClinicalTrials.gov were searched using the Medical Subject Headings social anxiety disorder and social phobia. Of the 438 selected articles, 20 were selected. Selective serotonin reuptake inhibitors are considered a first-line treatment for SAD due to their large effect size and database of evidence. Monoamine oxidase inhibitors, benzodiazepines, and the anticonvulsants pregabalin and gabapentin are also effective. Divergent results have been found for the serotonin-norepinephrine reuptake inhibitor venlafaxine. Amo

Japanese Society of Anxiety and Related Disorders/Japanese Society of Neuropsychopharmacology: Clinical practice guideline for social anxiety disorder (2021).

Asakura S, Yoshinaga N, Yamada H, Fujii Y, Mitsui N, Kanai Y · Neuropsychopharmacology reports · 2023

The development of clinical practice guidelines for social anxiety disorder began in March 2018 when the Joint Clinical Practice Guideline Development Committee for Anxiety and Obsessive-Compulsive Disorders was formed by the Japanese Society of Anxiety and Related Disorders and Japanese Society of Neuropsychopharmacology to jointly develop guidelines for anxiety and obsessive-compulsive disorders. Based on the universal concept of evidence-based medicine, three clinical questions (CQs) about pharmacotherapy and psychotherapy were developed for clinical guidelines for social anxiety disorder, panic disorders, and obsessive-compulsive disorder in accordance with the Minds "Manual for Guidelines Development 2017 by the Japan Council for Quality Health Care: CQ1-"What is the recommended pharmacotherapy for social anxiety disorder in adults?"; CQ2-"What is the recommended psychotherapy (psychological intervention) for social anxiety disorder in adults?"; and CQ3-"What are the recommendatio

Screening for Anxiety in Children and Adolescents: US Preventive Services Task Force Recommendation Statement.

US Preventive Services Task Force, Mangione CM, Barry MJ, Nicholson WK, Cabana M, Coker TR · JAMA · 2022

Anxiety disorder, a common mental health condition in the US, comprises a group of related conditions characterized by excessive fear or worry that present as emotional and physical symptoms. The 2018-2019 National Survey of Children's Health found that 7.8% of children and adolescents aged 3 to 17 years had a current anxiety disorder. Anxiety disorders in childhood and adolescence are associated with an increased likelihood of a future anxiety disorder or depression. The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for anxiety disorders in children and adolescents. This is a new recommendation. Children and adolescents 18 years or younger who do not have a diagnosed anxiety disorder or are not showing recognized signs or symptoms of anxiety. The USPSTF concludes with moderate certainty that screening for anxiety in children and adolescents aged 8 to 18 years has a moderate net benefit. The USPSTF conclud

The effects of Omega-3 supplementation on stress, anxiety, depression, sleep quality, and everyday memory in individuals with psychological distress: A randomized, double-blind, placebo-controlled trial.

Azhar W, Qadhi A, Abusudah W, Ghabashi M, Aljaadi AM, Alyamani R · Journal of affective disorders · 2026 · n=64

Psychological stress, anxiety, depression, memory impairment, and poor sleep quality are prevalent issues that affect individuals' quality of life and overall health. Omega-3 polyunsaturated fatty acids (PUFAs) have been suggested to have mood-regulating effects. However, there is lack of data on the effect of omega-3 supplementation on depression, stress, anxiety, everyday memory, and sleep quality on Saudi population. Therefore, this study aimed to evaluate the impact of omega-3 supplementation on stress, anxiety, depression, everyday memory, and sleep quality in individuals with severe psychological distress. A randomized, double-blind, placebo-controlled trial was conducted involving 64 participants with high levels of stress, anxiety, depression, memory issues and with poor quality of sleep with 32 allocated to the intervention group and 32 to the control group. The participants received either omega-3 supplementation (500 mg EPA + 250 mg DHA) or a placebo dai

Mobile Mindfulness Intervention for Psychological Distress Among Intensive Care Unit Survivors: A Randomized Clinical Trial.

Cox CE, Gallis JA, Olsen MK, Porter LS, Gremore T, Greeson JM · JAMA internal medicine · 2024 · n=247

Although psychological distress is common among survivors of critical illness, there are few tailored therapies. To determine the optimal method for delivering a mindfulness intervention via a mobile app for critical illness survivors. This randomized clinical trial used a 2 × 2 × 2 factorial design and was conducted at 3 sites among survivors of critical illness with elevated postdischarge symptoms of depression. The study was conducted between August 2019 and July 2023. Participants were randomized to 1 of 8 different groups as determined by 3 two-level intervention component combinations: intervention introduction method (mobile app vs therapist call), mindfulness meditation dose (once daily vs twice daily), and management of increasing symptoms (mobile app vs therapist call). The primary outcome was the 9-item Patient Health Questionnaire (PHQ-9) depression scale score (range, 0-27) at 1 month. Secondary outcomes included anxiety (7-item Ge

Effectiveness of acupuncture treatment in post-stroke depression and anxiety disorders: a prospective, randomized, controlled, single-blind study.

Kalaoğlu E, Kesiktaş FN, Bucak ÖF, Atasoy M, Günderci A · Acupuncture in medicine : journal of the British Medical Acupuncture Society · 2024

Our aim was to examine the effectiveness of acupuncture in post-stroke depression/anxiety disorders and to determine whether it reduces the need for anxiolytic and sedative drug use. This study included 54 stroke patients with depression and/or anxiety disorder. Patients were randomly assigned to the acupuncture treatment group (n = 27) or the control group (n = 27). A conventional rehabilitation program was applied to all patients and acupuncture was performed twice a week for 4 weeks. Patients were evaluated blindly by a psychiatrist at baseline (week 0), week 4 and week 8, using the Hamilton depression rating scale (HAM-D) and Hamilton anxiety rating scale (HAM-A), and drug doses were adjusted when necessary. The HAM-D and HAM-A scores at week 4 were pre-specified as the two primary outcome measures. Within each group, there was a significant decrease in the mean scores of HAM-D and HAM-A at weeks 4 and 8. No between-group differences in HAM-A or

The Gut Microbiome in Anxiety Disorders.

Butler MI, Kittel-Schneider S, Wagner-Skacel J, Mörkl S, Clarke G · Current psychiatry reports · 2025

We aim to update readers on the latest evidence regarding the role of the gut microbiome in generalized anxiety disorder (GAD), panic disorder (PD), agoraphobia, and social anxiety disorder (SAD). This review summarises the literature on microbiome composition and function in these conditions, provides insights about causality and mechanisms and evaluates current evidence for microbiome-based interventions in anxiety disorders. Most studies exploring the microbiome in anxiety disorders are small, cross-sectional studies. Nevertheless, some consistent findings emerge. Bacterial taxa such as Eubacterium, Coprococcus and Faecalibacterium may be depleted in GAD. Studies in PD and SAD are scarce and, to our knowledge, there have been no studies conducted in agoraphobia. Probiotics may help reduce anxiety symptoms, although the majority of studies have been in non-clinical cohorts. Large, prospective studies are required to further elucidate the role of the microbiome-gut-brain axis in anxi

Comparative Efficacy and Safety of Benzodiazepines in the Treatment of Patients with Generalized Anxiety Disorder: A Systematic Review and Network Meta-Analysis.

Fernandes H, Novais C, Sousa-Pinto B, Soares-da-Silva P, Azevedo LF · Psychotherapy and psychosomatics · 2025 · n=556

Guidelines recommend that benzodiazepines (BZDs) might be used as an add-on to antidepressant therapy during the first weeks of treatment of generalized anxiety disorder (GAD) or as a first-line and stand-alone. Our aim was to evaluate the comparative efficacy and safety of individual BZD in the treatment of patients with GAD. In this systematic review and network meta-analysis, we included randomized controlled trials including adults (≥18 years) with GAD and comparing BZD against placebo or an active intervention. We assessed the certainty of evidence using the confidence in network meta-analysis (CINeMA) framework. This study is registered with PROSPERO (registration number CRD42022330264). We included 56 studies (7,556 participants). The certainty of the evidence for the primary outcomes, as measured with CINeMA, varied from high to very low (overall; 40 comparisons scored "very low," 7 scored "low," and 814 scored "high"). Regarding efficacy, all BZDs, in general, were si

Psychotherapies for Generalized Anxiety Disorder in Adults: A Systematic Review and Network Meta-Analysis of Randomized Clinical Trials.

Papola D, Miguel C, Mazzaglia M, Franco P, Tedeschi F, Romero SA · JAMA psychiatry · 2024 · n=5048

Generalized anxiety disorder (GAD) is one of the most common mental disorders in adults. Psychotherapies are among the most recommended treatments for GAD, but which should be considered as first-line treatment needs to be clarified. To use a network meta-analysis to examine the short- and long-term associations of different psychotherapies with outcomes of effectiveness and acceptability in adults with GAD. MEDLINE, Embase, PsycINFO, and the Cochrane Register of Controlled Trials were searched from database inception to January 1, 2023, to identify randomized clinical trials (RCTs) of psychotherapies for adults with GAD. RCTs comparing any type of psychotherapy against another or with a control condition for the treatment of adults (≥18 years, both sexes) with a primary diagnosis of GAD were eligible for inclusion. This study followed Cochrane standards for extracting data and assessing data quality and used the PRISMA guideline for reporting. Risk of bias of individual stu

Mental health

WHO

The WHO provides fact sheets and information on various aspects of mental health, including anxiety disorders, outlining global perspectives on prevalence, causes, and effective interventions. It emphasizes the importance of mental health as a fundamental human right.

Treatments for anxiety

NHS

The NHS provides an overview of various treatments available for anxiety, including talking therapies, medicines, and self-help strategies. It aims to guide individuals on managing their anxiety.

Anxiety, fear and panic

NHS

This NHS page provides an overview of generalized anxiety disorder (GAD), including symptoms, causes, and treatment options. It offers practical advice for managing anxiety.

Anxiety Disorders

TRIP Database

TRIP Database is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice. It provides access to a vast collection of evidence-based resources on anxiety disorders.

TRIP Database Search: Anxiety Disorder

TRIP Database

TRIP Database is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support clinical practice. A search for 'Anxiety Disorder' provides access to a wide range of evidence-based resources, including guidelines, systematic reviews, and primary research.

TRIP Database Search: Anxiety

TRIP Database

TRIP is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence. A search for 'anxiety' provides access to a wealth of evidence-based information, including guidelines, systematic reviews, and primary research.