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Anxiety and Anxiety Disorders
The experience of fear can be considered as a basic behaviour that is necessary in the context of the individual's survival and can be observed in humans as well as in wildlife. Therefore, it is easier accessible in neurobiological research compared to other psychopathological changes or mental disorders.
Various forms of anxiety are prevalent in different developmental stages in children as well as in adolescence. While clinically relevant anxiety is less common in the general population, anxiety disorders belong to the most frequently mental disorders (in addition to affective disorders and addictive disorders) with a lifetime prevalence of 20%.
Classification systems (e.g., DSM-IV-R or ICD-10) usually distinguish between phobias such as specific (isolated), social or agoraphobia and other anxiety disorders like panic disorder, generalised anxiety disorder and posttraumatic stress disorder. Despite the existence of effective therapeutic approaches, still only a minority of patients receives sufficient treatment. On average, it requires up to seven years until patients suffering from an anxiety disorder obtain an adequate treatment.
Given the decreasing resources in the public health sector, it seems inevitable to generate strategies that allow the majority of patients to benefit from well-established methods of treatment. Therefore, in our research group, a cognitive-behavioural group therapy was developed for patients with panic disorder with or without agoraphobia. Its concept aims at the involvement of resources not only of various professional groups but also of the participating patients. Based on a close collaboration between out- and inpatient treatment strategies, individually designed therapies are provided.
In October 2002 the outpatient clinic specialised in anxiety disorders was opened. It provides diagnostic assessment as well as psychotherapeutic and psychopharmacological treatment of patients diagnosed with anxiety disorders, especially panic disorder with or without agoraphobia. In order to investigate the physiology and pathophysiology of anxiety, therapies are often conducted in the context of research projects. Thus, optimised and well-directed treatment approaches as well as the prevention of anxiety disorders are promoted.
Hence, the research group focuses on the following topics:
- The stress hormone system (i.e., hypothalamus-pituitary-adrenal (HPA) system and autonomic nervous system) plays a major role in the physiological reaction of fear and the pathophysiology of anxiety disorders. Its modulation and interaction with neuroactive steroids and the GABAA-receptor system were suggested to be associated with an altered stress response. In current studies the stress response of patients with anxiety disorders is inspected by the employment of well-established biomarkers.
- In the context of a multicenter psychotherapy study, sponsored by the BMBF (German ministry of education and research), patients with panic disorder and agoraphobia are examined with imaging techniques as well as genetic and electrophysiological methods. Additionally, effects of the augmentation of psychotherapy by a pharmacological agent (e.g. D-Cycloserine) are investigated.
- Physical exercise might have an impact on the development and treatment of mental disorders. Therefore, studies of our research group focus on anxiolytic effects of physical exercise as well as underlying mechanisms.
- Psychological and physical illness can influence each other reciprocally. Thus, the relationship between coronary heart disease and mental disorders, such as depression and anxiety disorders, is assessed in collaboration with the Berlin School of Public Health and the Clinic for Cardiology.
For more detailed information about diagnostics and therapy as well as background information of anxiety disorders, please visit www.angstambulanz-charite.de or call 030- 450 517217 / 517244.
Dipl.-Psych. Katja Beer
Dipl.-Psych. Sophie Bischoff
Dipl.-Psych. Mira Ertl
Dipl.-Psych. Katharina Gaudlitz
Dipl.-Psych. Johanna Gechter
Dipl.-Psych. Carolin Liebscher
M.Sc. Jennifer Mumm
Dr. med. Jens Plag
Dipl.-Psych. Lena Pyrkosch
Dipl.-Psych. Sarah Schumacher
Dr. rer. nat. Anja Siegmund
Dr. rer. medic. Meline Stoy
Dipl.-Psych. André Wittmann
Dipl.-Psych. Elisabeth Zschucke