Conclusions

There have been significant advances in understanding the psychobiology and management of anxiety disorders in recent years [5]. Nevertheless, more attention has been paid to vulnerability to these conditions than to the mechanisms underlying resilience, and there is much room for additional research in this latter area [118]. Furthermore, despite significant progress in this field, there is considerable evidence that the anxiety disorders remain underdiagnosed and undertreated [77,80].

Partnerships with primary care practitioners, consumer advocacy groups and communities may help to raise awareness of these disorders, decrease stigmatization, and encourage early diagnosis and treatment [119]. Further work is needed to fully understand the reasons for pervasive delays in help-seeking in those with anxiety disorders, and to effectively combat this [120,121]. There is a particular need for encouraging treatment-seeking in low referral groups such as children with anxiety disorders, or survivors of domestic violence [122].

Although further prospective long-term studies are needed, timely treatment may well be able to decrease the morbidity and comorbidity associated with the anxiety disorders [17,33]. Increasingly there is also a focus on the prevention of anxiety disorders [103]; there is already promising data in this area, and further effectiveness studies in the community should be undertaken. Future advances in the early detection and prevention of anxiety disorders will depend not only on advances in our understanding of their pathogenesis and molecular biology [123], but also on our ability to work with policy makers and communities to change the perception of psychiatric disorders and to develop innovative methodologies for combating them [21].

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