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Approach to Anxiety in the Medically Ill

  • Kyung Bong Koh
Chapter
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Abstract

To ascertain the degree to which a general medical condition or substance is a causative factor of a patient’s anxiety, the clinician should know whether the medical condition or substance has been closely associated with the anxiety symptoms in the literature. Assessment of anxiety in the medically ill requires examining biologic as well as psychosocial factors. In particular, clinicians should address the major psychologic issues, such as isolation, dependency, loss of bodily integrity, and dying that are known to be commonly associated with anxiety in the medically ill. Management of the physical disease-induced anxiety should be preceded by treatment of the physical diseases. The primary treatment of substance-induced anxiety disorder is the removal of the causally involved substance. However, any successful intervention for these patients should be a biopsychosocial approach that includes psychopharmacological and psychosocial treatment. Benzodiazepine or nonbenzodiazepine anxiolytics and antidepressants may be helpful in decreasing anxiety symptoms in the medically ill. Psychosocial treatment includes providing accurate medical information (e.g., diagnosis and prognosis), explaining the role and meaning of the monitoring equipment, providing emotional support and reassurance, and reinforcing the appropriate use of denial. For patients with persistent anxiety symptoms, cognitive and behavioral strategies can be used.

Keywords

Medical condition Substance Anxiety Biologic Psychosocial factors Biopsychosocial approach 
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© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Kyung Bong Koh
    • 1
  1. 1.Department of PsychiatryYonsei University College of MedicineSeoulKorea

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