PDF(Pubmed)
Abstract：
OBJECTIVE: Treatment guidelines with respect to unspecified anxiety disorder have not been published. The aim of this study was to develop a consensus among field experts on the management of unspecified anxiety disorder.
METHODS: Experts were asked to evaluate treatment choices based on eight clinical questions concerning unspecified anxiety disorder using a nine-point Likert scale (1 = \"disagree\" to 9 = \"agree\"). According to the responses from 119 experts, the choices were categorized into first-, second-, and third-line recommendations.
RESULTS: Benzodiazepine anxiolytic use was not categorized as a first-line recommendation for the primary treatment of unspecified anxiety disorder, whereas multiple nonpharmacological treatment strategies, including coping strategies (7.9 ± 1.4), psychoeducation for anxiety (7.9 ± 1.4), lifestyle changes (7.8 ± 1.5), and relaxation techniques (7.4 ± 1.8), were categorized as first-line recommendations. Various treatment strategies were categorized as first-line recommendations when a benzodiazepine anxiolytic drug did not improve anxiety symptoms, that is, differential diagnosis (8.2 ± 1.4), psychoeducation for anxiety (8.0 ± 1.5), coping strategies (7.8 ± 1.5), lifestyle changes (7.8 ± 1.5), relaxation techniques (7.2 ± 1.9), and switching to selective serotonin reuptake inhibitors (SSRIs) (7.0 ± 1.8). These strategies were also highly endorsed when tapering the dosage of or discontinuing benzodiazepine anxiolytic drugs. There was no first-line recommendation regarding excusable reasons for continuing benzodiazepine anxiolytics.
CONCLUSIONS: The field experts recommend that benzodiazepine anxiolytics should not be used as a first-line option for patients with unspecified anxiety disorder. Instead, several nonpharmacological interventions and switching to SSRIs were endorsed for the primary treatment of unspecified anxiety disorder and as alternatives to benzodiazepine anxiolytics.
METHODS: Experts were asked to evaluate treatment choices based on eight clinical questions concerning unspecified anxiety disorder using a nine-point Likert scale (1 = \"disagree\" to 9 = \"agree\"). According to the responses from 119 experts, the choices were categorized into first-, second-, and third-line recommendations.
RESULTS: Benzodiazepine anxiolytic use was not categorized as a first-line recommendation for the primary treatment of unspecified anxiety disorder, whereas multiple nonpharmacological treatment strategies, including coping strategies (7.9 ± 1.4), psychoeducation for anxiety (7.9 ± 1.4), lifestyle changes (7.8 ± 1.5), and relaxation techniques (7.4 ± 1.8), were categorized as first-line recommendations. Various treatment strategies were categorized as first-line recommendations when a benzodiazepine anxiolytic drug did not improve anxiety symptoms, that is, differential diagnosis (8.2 ± 1.4), psychoeducation for anxiety (8.0 ± 1.5), coping strategies (7.8 ± 1.5), lifestyle changes (7.8 ± 1.5), relaxation techniques (7.2 ± 1.9), and switching to selective serotonin reuptake inhibitors (SSRIs) (7.0 ± 1.8). These strategies were also highly endorsed when tapering the dosage of or discontinuing benzodiazepine anxiolytic drugs. There was no first-line recommendation regarding excusable reasons for continuing benzodiazepine anxiolytics.
CONCLUSIONS: The field experts recommend that benzodiazepine anxiolytics should not be used as a first-line option for patients with unspecified anxiety disorder. Instead, several nonpharmacological interventions and switching to SSRIs were endorsed for the primary treatment of unspecified anxiety disorder and as alternatives to benzodiazepine anxiolytics.
摘要：
目的：关于未指明焦虑症的治疗指南尚未公布。这项研究的目的是在未指明的焦虑症的管理领域专家之间达成共识。
方法：专家们被要求根据八个关于未指明的焦虑症的临床问题，使用九分利克特量表（1=“不同意”至9=“同意”）评估治疗选择。根据119位专家的回应，选择被分类为第一-，第二-，和第三线建议。
结果：苯二氮卓抗焦虑药的使用未被归类为一线推荐用于非特定焦虑症的主要治疗。而多种非药物治疗策略，包括应对策略(7.9±1.4)，焦虑心理教育(7.9±1.4)，生活方式改变（7.8±1.5），和松弛技术（7.4±1.8），被归类为一线建议。当苯二氮卓抗焦虑药物不能改善焦虑症状时，各种治疗策略被归类为一线建议。也就是说,鉴别诊断（8.2±1.4），焦虑心理教育（8.0±1.5），应对策略(7.8±1.5)，生活方式改变（7.8±1.5），弛豫技术（7.2±1.9），并改用选择性5-羟色胺再摄取抑制剂（SSRIs）（7.0±1.8）。当逐渐减少苯二氮卓抗焦虑药物的剂量或停用时，这些策略也得到了高度认可。没有关于继续使用苯二氮卓抗焦虑药的可原谅原因的一线建议。
结论：领域专家建议，苯二氮卓抗焦虑药不应该被用作非特定焦虑症患者的一线选择。相反，一些非药物干预措施和改用SSRIs被批准用于未明确的焦虑症的主要治疗,并作为苯二氮卓抗焦虑药的替代品.
方法：专家们被要求根据八个关于未指明的焦虑症的临床问题，使用九分利克特量表（1=“不同意”至9=“同意”）评估治疗选择。
结果：苯二氮卓抗焦虑药的使用未被归类为一线推荐用于非特定焦虑症的主要治疗。
结论：领域专家建议，苯二氮卓抗焦虑药不应该被用作非特定焦虑症患者的一线选择。
