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Generalised Anxiety Disorder in Adults: Management in Primary, Secondary and Community Care

Generalised Anxiety Disorder in Adults: Management in Primary, Secondary and Community Care

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK)

Version: 2011


The use of pharmacological interventions to manage anxiety is a far from recent phenomenon; for example, the consumption of alcohol and opiates for this purpose dates back centuries. In the 19th and early 20th century, medicines containing bromides were often prescribed by clinicians to treat what would then have been called ‘anxiety neurosis’ (Schwartz et al., 2005). The mid-20th century saw the introduction of barbiturates followed by the benzodiazepines, which were widely used for the medical treatment of anxiety between the 1960s and the 1980s. Towards the end of this period the limitations of benzodiazepines in terms of tolerance and dependence became apparent and at the same time the therapeutic benefits of anti-depressants in treating various kinds of anxiety disorders were more widely recognised (Davidson et al., 2010b).


This chapter provides an overview of the experience of people with GAD and other anxiety problems, and their families/carers. The first section comprises first-hand personal accounts written by people with GAD and other anxiety problems and carers; the accounts provide some experiences of having a diagnosis of GAD, accessing services, having treatment and caring for someone with an anxiety problem. It should be noted that these accounts are not representative of the experiences of people with GAD and therefore can only ever be illustrative. The second section of the chapter includes a review of the qualitative and quantitative literature, which provides a basis for the recommendations, which appear in the final section.

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