Anxiety Across the Lifespan

It is my great pleasure to introduce this Spring issue of Focus on the theme of “Anxiety Across the Lifespan.” Anxiety disorders continue to be a major public health and clinical practice challenge because of their high prevalence, chronicity, and clinical comorbidities. It is striking that, despite the availability of modern psychiatric care, many patients remain underrecognized and undertreated. Also striking is the fact that in recent years relatively few novel antianxiety treatments have become available.

However, our field is undergoing a remarkable time of change with regard to diagnostic reconceptualization, neuroscientific models of fear processing, and emerging treatment innovations. I hope this issue captures the essence of some of these trends and their implications for the management of anxiety disorders. The opening article provides an update on the status of psychiatry’s diagnostic and treatment approaches for anxiety, emphasizing new research ideas and findings and their immediate relevance for practice (1). Several subsequent articles highlight developmental aspects of anxiety disorders, explicating the need to adapt assessment and treatment strategies according to life phases. For anxious children and adolescents (2), we see that a multidimensional assessment process is critical and treatment approaches should emphasize psychosocial interventions, whereas for elderly patients (3), unusual presentations of anxiety, such as fear of falling, as well as the impact of anxiety on cognition, are becoming better appreciated. Additional articles address the major impact and relevance of anxiety disorders across the lifespan of anxiety in special populations. For example, among women with clinical anxiety, a comprehensive assessment and treatment plan should take into account hormonal status and reproductive events (4). For anxious patients who have comorbid general medical problems, we are learning that poorer outcomes than with either condition alone are to be expected (5). Moreover, collaborative care service models are emerging as efficient approaches to meet the needs of those with anxiety and medical illness.

I am extremely grateful to my colleagues, all renowned clinical research experts in the field, for their outstanding contributions to this issue. Furthermore, I acknowledge the major contributions of the Focus editorial team for integrating the papers into a cohesive collection. I trust that your journey through this volume will be engaging, enjoyable, and edifying.