Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-05T21:15:08.102Z Has data issue: false hasContentIssue false

Problems in the classification of anxiety disorders

Published online by Cambridge University Press:  28 April 2020

J.J. López-Ibor Jr*
Affiliation:
Psychiatry Teaching Unit, University of Alcalá de Henares; and Psychiatric Unit, Ramón y Cajal Hospital, Madrid, Spain
Get access

Summary

The classification of neurotic disorders still remains an unresolved problem. It has even been argued that there is no necessity to classify such unspecific reaction modes. Nevertheless, modern clinical research and new treatments both suggest and require that distinctions be made in the realm of neurotic disorders. DSM-III has paved the way for classifications based on symptoms, a trend present in DSM-IV and ICD-10 (Table I) drafts. However, the history of those disorders becomes blurred with this approach, and certain questions arise; for instance, what the relationship is between childhood separation anxiety and panic attacks in the adult, or between the latter and agoraphobia, or between childhood separation anxiety and major depression. Some longitudinal data, including that included in the present paper (Tables II—V), suggest a close relationship between these disorders, which is very much in contrast with what occurs in generalized anxiety disorders. Both patients with panic disorder and those suffering from general anxiety disorder tend to become chronic somatizers with advancing age, as is shown in the data presented in this paper.

Résumé

Résumé

La classification des troubles névrotiques est encore un problème non résolu. Il a même été dit qu'il n'y avait aucun besoin de classification de ce qui n'est qu'une forme de réaction non spécifique de la nature humaine. Toutefois les nouvelles recherches cliniques et les nouveaux traitements ont fait surgir des perspectives et des besoins différents obligeant à faire des distinctions plus précises dans le champs des troubles névrotiques. Le DSM-III a ouvert le chemin à des classifications basées sur les symptômes, tendence qui se poursuit actuellement dans le DSM-IV et ICD-10 (Table I) en cours de rédaction. Malgré tout, cette perspective symptomatique obscurcit l'histoire naturelle de ces troubles et des questions nombreuses surgissent. Par exemple, quelles sont les rapports entre l'anxiété de séparation des enfants, les crises de panique des adultes ou entre ces deux troubles et l'agoraphobie ou les dépressions majeures? Quelques données de recherches longitudinales, parmi elles ceux de l'article présent (Tables II-V) suggèrent l'existence de rapports étroits entre tous ces troubles, ce qui est en contraste avec ce qui est trouvé, dans les troubles d'anxiété généralisée. Mais d'une autre part les deux types de troubles, panique et anxiété généralisée, tendent en devenant chroniques à se manifester sous la forme de «somatdations chroniques».

Type
Original article
Copyright
Copyright © European Psychiatric Association 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexander, F.French, T.N. & Pollock, G.H. (1968) Psychosomatic Specificity. University of Chicago Press, Chicago, LondonGoogle Scholar
American Psychiatric Association (1988) DSM-III-R (Spanish version). Masson SA, BarcelonaGoogle Scholar
Baeyer, W.V. (1984) Angst as erlebtes Bedrohtsein. Nervenarzt 55, 349357Google Scholar
Bakan, D. (1968) Disease, Pain and Sacrifice. Towards a Psychology of Suffering. Univ. of Chicago Press, ChicagoGoogle Scholar
Goldberg, D.P. & Bridges, K. (1987) The determinants of somatization. 9th World Congress of the International College of Psychosomatic Medicine (Sydney, Australia) Book of Abstracts. The Royal Australian and New Zeland College of Psychiatrists, p. 65Google Scholar
Klerman, G.L. : (1983) The scope of depression. In: The Origin of Depression: Current Concepts and Approaches (Angst, J., ed.), Springer, Berlin, pp. 525CrossRefGoogle Scholar
López-Ibor, J.J. Jr. (1950) La Angustia Vital. Paz Montalvo, MadridGoogle Scholar
López-Ibor, J.J. Jr., (1966) Las Neurosis como Enfermedades del Animo. Gredos, MadridGoogle Scholar
López-Ibor, J.J. Jr. (1982) Las neurosis. In: Psiquiatria (López-Ibor, J.J. Jr.Ruiz Ogara, C. & Bacia, D., eds.), Toray, Barcelona, vol. 2, pp. 741787Google Scholar
López-Ibor, J.J. Jr., Soria, J.Canas, F. & Rodriguez-Camazo, M. (1985) Psychological aspects of the toxic oil syndrome catastrophe. Br. J. Psychiatry 147, 352365CrossRefGoogle ScholarPubMed
López-Ibor, J.J. Jr. (1982) Las psicosis y los trastornos afectivos.In: Psiquiatria (López-Ibor, J.J. Jr.Ruiz Ogara, C. & Barcia, D., eds.), Toray, Barcelona, vol. 2, pp. 910991Google Scholar
López-Ibor, J.J. Jr. & Jimenez Arriero, M.A. (1987) Psychosocial rehabilitation in disasters: experience of the Spanish toxic oil syndrome. Int. J. Disabil. Stud. 9, 8183CrossRefGoogle ScholarPubMed
Nunberg, H. & Federn, E. (1962) In: Minutes of the Vienna Psychoanalytic Society (1906-1908). International University Press, New York, vol. 1Google Scholar
Pichot, P. (1985) In: Un siècle de Psychiatrie. Roche, ParisGoogle Scholar
Roth, M. & Mountjoy, C.A. (1982) The distinction between anxiety states and depressive disorders. In: Handbook of Affective Disorders (Paykel, E.S., ed.), Churchill-Livigstone, EdinburghGoogle Scholar
Rubio Valladolid, J.L. (1988) Evolución de los trastornos de ansiedad : estudio catamnésico de la timopatía ansiosa. Doctoral Thesis, Alcald de Henares, Madrid, SpainGoogle Scholar
Sartre, J.P. (1939) Esquisse d'une Théorie des Emotions. Hermann, ParisGoogle Scholar
Schneider, K. (1967) Klinisch Psychopathologie. Thieme, Stuttgart, 8th edn.Google Scholar
Selye, H. (1956) The Stress of Life. McGraw Hill, New YorkGoogle Scholar
Weitbrecht, H.J. (1968) Psicopatología comparada de los estados depresivos. Actas Luso-Esp. Neurol. Psiquiatr. 27, 407419Google Scholar
World Health Organization (1988) International Classification of Diseases. 1988 Draft of ch. V, Categories F00-F99, Mental, Behavioural and Developmental Disorders. Clinical Description and Diagnostic Guidelines. WHO, Division of Menial Health, Geneva (MNH/MHP/87.1 Rev. 2)Google Scholar
Submit a response

Comments

No Comments have been published for this article.