Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun;272(4):571-582.
doi: 10.1007/s00406-021-01324-1. Epub 2021 Oct 5.

The German Guidelines for the treatment of anxiety disorders: first revision

Affiliations

The German Guidelines for the treatment of anxiety disorders: first revision

Borwin Bandelow et al. Eur Arch Psychiatry Clin Neurosci. 2022 Jun.

Abstract

Starting in 2019, the 2014 German Guidelines for Anxiety Disorders (Bandelow et al. Eur Arch Psychiatry Clin Neurosci 265:363-373, 2015) have been revised by a consensus group consisting of 35 experts representing the 29 leading German specialist societies and patient self-help organizations. While the first version of the guideline was based on 403 randomized controlled studies (RCTs), 92 additional RCTs have been included in this revision. According to the consensus committee, anxiety disorders should be treated with psychotherapy, pharmacological drugs, or their combination. Cognitive behavioral therapy (CBT) was regarded as the psychological treatment with the highest level of evidence. Psychodynamic therapy (PDT) was recommended when CBT was not effective or unavailable or when PDT was preferred by the patient informed about more effective alternatives. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) are recommended as first-line drugs for anxiety disorders. Medications should be continued for 6-12 months after remission. When either medications or psychotherapy were not effective, treatment should be switched to the other approach or to their combination. For patients non-responsive to standard treatments, a number of alternative strategies have been suggested. An individual treatment plan should consider efficacy, side effects, costs and the preference of the patient. Changes in the revision include recommendations regarding virtual reality exposure therapy, Internet interventions and systemic therapy. The recommendations are not only applicable for Germany but may also be helpful for developing treatment plans in all other countries.

Keywords: Anxiety disorders; Drug treatment; Generalized anxiety disorder; Guideline; Panic disorder; Psychotherapy; Social phobia; Treatment.

PubMed Disclaimer

Conflict of interest statement

All participants in the guideline panel have declared their conflicts of interest (e.g., having received lecture honoraria from drug manufacturers or being a leading member of a group which advocates a particular form psychotherapy school). The guideline committee undertook every effort to base its recommendations exclusively on objective evaluation of the scientific evidence. Participants with a relevant conflict of interest abstained when recommendations on the treatment in question came to vote. In the past 36 months, Dr Bandelow has been on the speakers’ board for Janssen, Lilly, Pfizer, Roche and Schwabe on the advisory board for Cannaxan, Lundbeck and Pfizer. Dr Werner, Dr Kopp, Dr Rudolf, Dr Wiltink and Dr Beutel declare that no conflicts of interest exist.

Figures

Fig. 1
Fig. 1
PRISMA statement [24]. Newly included studies since 16/09/2013

References

    1. Andrews G, Bell C, Boyce P, Gale C, Lampe L, Marwat O, Rapee R, Wilkins G. Royal australian and new zealand college of psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Aust N Z J Psychiatry. 2018;52:1109–1172. doi: 10.1177/0004867418799453. - DOI
    1. ÄZQ/AWMF . Deutsches instrument zur methodischen leitlinien-bewertung (delbi) AWMF; 2008. pp. 468–519.
    1. Baldwin DS, Anderson IM, Nutt DJ, Allgulander C, Bandelow B, den Boer JA, Christmas DM, Davies S, Fineberg N, Lidbetter N, Malizia A, McCrone P, Nabarro D, O'Neill C, Scott J, van der Wee N, Wittchen HU. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the british association for psychopharmacology. J Psychopharmacol. 2014;28:403–439. doi: 10.1177/0269881114525674. - DOI - PubMed
    1. Bandelow B, Aden I, Alpers GW, Benecke A, Benecke C, Beutel ME, Deckert J, Domschke K, Eckhardt-Henn A, Geiser F, Gerlach AL, Harfst TH, Hoffmann S, Hoyer J, Hunger-Schoppe C, Kellner M, Köllner V, Kopp I, Langs G, Liebeck H, Matzat J, Ohly M, Rüddel HP, Rudolf S, Scheufele E, Simon R, Staats H, Ströhle A, Waldherr B, Wedekind D, Werner AM, Wiltink J, Wolters JP. Deutsche s3-leitlinie behandlung von angststörungen, version 2. AWMF; 2021.
    1. Bandelow B, Baldwin D, Abelli M, Altamura C, Dell'Osso B, Domschke K, Fineberg NA, Grunblatt E, Jarema M, Maron E, Nutt D, Pini S, Vaghi MM, Wichniak A, Zai G, Riederer P. Biological markers for anxiety disorders, ocd and ptsd—a consensus statement. Part i: neuroimaging and genetics. World J Biol Psychiatry. 2016;17:321–365. doi: 10.1080/15622975.2016.1181783. - DOI - PubMed

MeSH terms

Substances

LinkOut - more resources