Anxiety disorders are common, have an early onset, run a long course, cause substantial distress, impair overall function, reduce quality of life and impose a major economic burden, and therefore represent an important public health problem. Many patients do not present or are not recognized, the standard of care is often sub-optimal, and the effectiveness of interventions in real-world practice can be disappointing: there is considerable room for improvement in recognition, care and treatment.

The causes remain largely unknown and this hinders accurate diagnosis, prediction of prognosis, and development of refined treatment approaches. There is much co-morbidity between the disorders and with conditions such as bipolar disorder, depressive illness and physical illness. Research findings in patient samples without co-morbidity may have limited applicability to wider practice, and there is a need to undertake research in fully representative groups. Little is known about determinants of non-response, or next steps in management after the failure of first-line interventions, and there is a clear need for research in the substantial proportion with ‘treatment-resistant’ conditions.

The unmet public health, clinical and research needs could therefore be addressed by developing an independent collaborative European Anxiety Disorders Research Network. This would facilitate harmonization of research and clinical databases and refinement of research methodologies. It should contribute to greater accuracy when predicting clinical outcome, and encourage the evaluation of innovative interventions, particularly in important groups such as in the early stages of illness, those with comorbid disorders, and those who have not responded to initial treatment approaches.