April/May 2011 (vol. 07/6)

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Adult anxiety disorder guidelines

Generalised anxiety disorder affects nearly one in 20 adults (4.4%). Updated guidelines from the National Institute of Health and Clinical Excellence (NICE) include an increased evidence base, wider choice of psychological interventions and more focused evidence for the use of selective serotonin reuptake inhibitors. Applied relaxation (teaching coping skills to promote relaxation) is included as an alternative to cognitive behavioural therapy (CBT) and more emphasis is given to patient preference on the choice of drug or psychological treatments. The stepped-care approach is slimmed down to four stages: (1) identification, assessment, education and monitoring; (2) low intensity psychological treatments based on CBT principles; (3) choice of high-intensity psychological intervention (CBT/applied relaxation) or drug treatment; (4) specialist treatment such as drug and/or psychological interventions.

NICE Clinical Guideline 113. London: NICE 2011. http://www.nice.org.uk/guidance/CG113

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Occupational Health at Work April/May 2011 (vol. 07/6) pp49