Updates in Anxiety Disorders

Dear Colleagues,

Since the advent of the DSM-5, attention has been given to providing a more sophisticated scientific approach to the possible etiology and pathogenesis of anxiety disorders. The reformulation of anxiety disorders in DSM-5 led to greater precision in defining clinical boundaries with other psychiatric disorders and identifying their biological correlates. Parallel, translational research data and discovery of biological markers in subgroup diagnoses and treatment predictors have been more easily mapped onto DSM-5 formulation. At present, anxiety disorders occupy an autonomous placement between DSM-5 chapters on depression and obsessive–compulsive disorders. Anxiety disorders include conditions traditionally belonging to childhood (separation anxiety, selective mutism, and specific phobia) and conditions more typical of adulthood (social anxiety disorder, panic disorder, agoraphobia, and generalized anxiety disorder). Interestingly, the introduction of the panic attack specifier broadened the possibility to recognize panic symptoms within the realm of other mental and physical disorders. 

The most important change to the classification of anxiety disorders was generated by the DSM-5 concerns separation anxiety disorder. Separation anxiety has traditionally been defined as a childhood phenomenon. This disorder is conceptually rooted in both developmental research and attachment theory. Distress upon separation from one’s attachment figure is the developmental norm during early childhood and is considered to be an evolutionarily adaptive mechanism designed to keep the defenseless child in close proximity to their adult caregiver. Only when the separation distress becomes prolonged, excessive, and developmentally inappropriate or impairing is a psychiatric diagnosis typically made. The estimated prevalence of childhood separation anxiety disorder is 4%. However, several studies have indicated that separation anxiety occurs frequently in adulthood, with prevalence rates around 6%. In the DSM-5, the wording of the criteria for separation anxiety disorder has been modified to more adequately represent the expression of separation anxiety symptoms in adulthood. Thus, the diagnostic criteria no longer specify that onset must be before age 18 years. Adult separation anxiety may also occur in response to the disruptions and losses associated with other severe mental disorders, such as bipolar disorder. Severe separation anxiety disorder may also present in a variety of ways—for example, as suicidal behaviors or stalking in response to actual or threatened separations—which are not indicated in the DSM-5 criteria for the disorder.

I invite authors and research groups to participate in this Special Issue, which aims to collect the most recent advances in clinical phenomenology, biology, and treatment of anxiety disorders across individual’s lifespan.

The manuscripts may include any format (original article, systematic review, state-of-the-art review) that may contribute to the further understanding phenomenology in the area of anxiety disorders. This includes, but is not limited to, manuscripts on classification of anxiety disorders, their comorbidities, and long-term outcomes.

Prof. Dr. Stefano Pini
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• anxiety disorders
• separation anxiety disorder
• DSM-5 criteria
• clinical phenomenology
• biology
• diagnosis
• treatment