THE ANXIETY DISORDERS CLINIC

Founded in 1982, the Anxiety Disorders Clinic was the first in the nation devoted to research and treatment of anxiety problems. Although the idea that anxiety could take the form of specific disorders had been increasingly recognized, little systematic information about these disorders was available at the time. The clinic has been a driving force behind the recent advances in the recognition, understanding, and/or treatment of anxiety disorders such as posttraumatic stress disorder, panic disorder, social phobia, obsessive-compulsive disorder and others. Our counterpart Hispanic Clinic offers research treatment in Spanish and is a valuable asset in the community.

Integrating Medication and Psychotherapy Treatments

While the Anxiety Disorders Clinic has been very much a part of the biological revolution that has transformed psychiatry, it has also taken a leading role in comparing and combining medication with cognitive behavioral treatments that have recently been shown to benefit anxiety disorders. Through collaborations with developers of innovative behavioral approaches in a Philadelphia research clinic, the Anxiety Disorders Clinic has developed new methods for the comparison of medication and behavioral therapy treatments for social phobia and obsessive-compulsive disorder. After rigorous scrutiny at academic centers of differing "ideological" bents, these collaborations have enhanced the acceptance of the new and effective treatments and have become a model for the profession.

Anxiety Disorders Clinic researchers recently demonstrated the effectiveness of medication for the treatment of hypochondriasis. They have also expanded their research to include studies of the role of childhood trauma in patients with anxiety disorders, the psychiatric manifestations of Lyme disease, and various treatments for posttraumatic stress disorder and somatization disorder.

Obsessive Compulsive Disorder

Obsessive Compulsive Disorder (OCD), characterized by excessive washing or checking behaviors, was considered rare and extremely difficult to treat until the treatment discoveries of the past 15 years. The Anxiety Disorders Clinic participated in the first testing of serotonin reuptake inhibitors for OCD. These medications are now a mainstay of OCD treatment. Other research in the clinic has helped clarify the role of the neurotransmitter serotonin in OCD and the role of therapy in the treatment of OCD.
To learn more about obsessive-compulsive disorder, click on OCD.

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD) is a condition that can develop after a shocking, violent, or severely upsetting event such as aggravated assault, rape, sexual and physical abuse, natural disaster or a serious accident. Posttraumatic Stress Disorder can affect anyone at any age. Recent surveys show that approximately 7% of Americans have suffered from PTSD. Unfortunately, the vast majority of individuals with symptoms of PTSD never get help, even though new research has identified a number of potentially effective treatments.
To learn more about Posttraumatic Stress Disorder, click on PTSD.

Social Anxiety Disorder/Social Phobia

An internationally recognized program in the research and treatment of social anxiety offers free evaluation and free treatment for eligible adults who suffer from Social Anxiety Disorder, also known as Social Phobia. The hallmark of social anxiety disorder is an excessive fear of embarrassment or of being judged negatively. People with social phobia are uncomfortable in one or more social or public situations, such as speaking up at a meeting, starting a conversation, or participating in discussion with a group of people. The anxiety can be limited to one situation (public speaking is the most common) or generalized to most social situations, taking the form of painful shyness. People with social phobia may find it difficult to make new friends and to date, and they may find career opportunities limited by their anxiety. Sweating, trembling or blushing may make self-consciousness worse. Social phobia usually begins in childhood or early adulthood and, if not treated, often persists throughout life, sometimes leading to additional problems, such as alcoholism or depression. Fortunately, socially phobia is highly responsive to available treatments.
To learn more about social phobia/social anxiety disorder and research studies, click on Social Anxiety Disorder.

Panic Disorder and Agoraphobia

The Anxiety Disorders Clinic helped pioneer discovery of the specific physiology of panic disorder. This condition is characterized by panic attacks (sudden episodes of symptoms such as difficulty breathing, palpitations, dizziness, and fear of dying or losing control). It is often complicated by the development of phobias of traveling, being in a crowd, and other situations where panic attacks could be especially problematic. Sufferers visit emergency rooms frequently and often become housebound by agoraphobia (the fear of open spaces) or multiple phobias. Early theories had postulated that panic disorder resulted from emotional conflicts, but traditional long term psychotherapy was not always effective.

In exploring the origins of panic disorder, the Anxiety Disorders Clinic showed that sodium lactate, given intravenously in a research laboratory, triggered panic attacks regularly in persons with panic disorder but not in others. Pretreating these panic disorder patients with imipramine, an antidepressant medication, blocked the panic inducing effect of lactate, demonstrating that panic disorder had a strong biological component. This recognition, in turn, led to the natural development of the Biological Studies Unit designed to study panic attacks further in a laboratory setting. It also encouraged the development of a variety of effective medications, many tested in the Anxiety Disorders Clinic, which have greatly relieved the suffering of these patients and have turned panic disorder into one of the most treatable disorders in medicine. The most recent and effective class of medications, serotonin reuptake inhibitors, was first tested as a treatment for panic disorder at the Anxiety Disorders Clinic.

Pathological (or compulsive) gambling

Pathological gambling, also known as compulsive gambling and gambling addiction, is characterized by a chronic and progressive inability to resist impulses to gamble that disrupts the life of the individual and, in many cases, the lives of those around him. Clinicians and investigators are becoming more interested in pathological gambling, and there is a growing awareness among the general public as well due to its increasing prevalence in the population during the last years.
To learn more about this disorder, click on Pathological Gambling.

Hispanic Clinic

The Anxiety Disorders Clinic provides a unique resource for the Hispanic community through the development a program that offers treatment by Spanish speaking staff. Research in the Hispanic Clinic has focused on assessing treatments for anxiety and depressive disorders, and has conducted some of the first systematic studies of a culturally distinct anxiety syndrome, ataque de nervios. The success of this work has led to a pilot program in which the Anxiety Disorders Clinic assists Presbyterian Hospital clinics to reach out to the Hispanic community.
For information in Spanish, click on El programa Hispano de tratamiento.