Morbid Anxiety as a Risk Factor in Patients with Somatic Diseases: A Review of Recent Findings

Allgulander C.  Morbid Anxiety as a Risk Factor in Patients with Somatic Diseases:  A Review of Recent Findings.  European Neurological Journal, June 2010; 2(1):  31-39

Review Article


Christer Allgulander

Affiliation: Karolinska Institutet Department of Clinical Neuroscience, Section of Psychiatry, Karolinska University Hospital – Huddinge, Sweden


ABSTRACT

This review focuses on anxiety in patients with somatic diseases, based on studies published from 2007 through January 2010. It covers neurological, cardiovascular, respiratory, and endocrine diseases as well as HIV/AIDS, trauma, skin conditions, and other somatic diseases. Anxiety may be an acute and adequate reaction to receiving a diagnosis of a disabling or life‐threatening disease. It may also be precipitated by stroke, injury, or the distress of having to manage diabetes or AIDS. Several studies show that anxious patients inflate self‐perceived health problems and are more sensitive to physical symptoms in a manner disproportionate to objective disease validators. Therefore, intervention should be reserved for those patients most likely to benefit from reduced anxiety, improved management of the somatic condition, and improved functioning.

This issue is particularly important for the elderly, who represent a growing global challenge. Late‐onset anxiety may be caused by loneliness and bereavement, and can be compounded by immobilization and somatic disease. Controlled treatment studies of anxiolytics as well as their potential benefits in the overall management of anxious patients with somatic disease are generally lacking. Research to determine the benefits and costs of such treatments in primary and tertiary care is currently underway.

Keywords: anxiety disorders, stroke, diabetes, COPD, pain, IBS, SLE
Correspondence: Christer Allgulander , M.D., Associate Professor, Senior Lecturer, Karolinska Institutet, Department of Clinical Neuroscience, Section of Psychiatry, M56 Karolinska University Hospital – Huddinge, SE 141 86 Huddinge, Sweden. e‐mail: Christer.Allgulander@ki.se