ArticleWorld psychiatry : official journal of the World Psychiatric Association (WPA)2024
The definition of treatment resistance in anxiety disorders: a Delphi method-based consensus guideline.
Article in World psychiatry : official journal of the World Psychiatric Association (WPA), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Beyond fear circuits: multiscale neurobiological architecture of panic disorder.Molecular psychiatry · 2026Pooled it
- Ketone Supplementation Decreased Lipopolysaccharide-Generated Anxiety-like Behavior in Female WAG/Rij Rats.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Permissive and instructive causality: integrating biological and environmental factors in mental health.Psychological medicine · 2026Review
- Next-Generation Neuromodulation for Anxiety: Circuit-Based and Personalized Approaches.Current psychiatry reports · 2026Review
- Risk of all-cause and cause-specific mortality, and suicide attempt in people with anxiety and stress-related disorders: a systematic review, meta-analysis and meta-regression analysis of 165 studies.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Evaluation of free radical scavenging and anxiolytic activities ofFrontiers in pharmacology · 2026Article
- Exercise as an adjunct intervention for social anxiety disorder: a mini-review.Frontiers in psychology · 2026Review
- Severe PTSD or just PTSD?European journal of psychotraumatology · 2025Article
- Sustainability of Treatment Success 5 Years after Exposure-Based Cognitive-Behavioral Therapy for Anxiety Disorders.Psychotherapy and psychosomatics · 2025Article
- Generalized additive mixed models to discern data-driven theoretically informed strategies for public brain, cognitive and mental health.European journal of epidemiology · 2025Article
- A panoramic review of transcranial focused ultrasound neuromodulation: from basic research to clinical applications.Journal of neuroengineering and rehabilitation · 2025Review
- Beyond symptom improvement: transdiagnostic and disorder-specific ways to assess functional and quality of life outcomes across mental disorders in adults.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2025Article
- Epigenetic markers of disease risk and psychotherapy response in anxiety disorders - a longitudinal analysis of the DNA methylome.Molecular psychiatry · 2025Article
- Difficult-to-Treat Anxiety: A Neurocomputational Framework.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2025Review
- The Organization of Anxiety Symptoms Along the Threat Imminence Continuum.Current topics in behavioral neurosciences · 2025Review
- Case Report: Generalized anxiety disorder and hypertension: a bidirectional loop unraveled by integrated management.Frontiers in psychiatry · 2025Article
- Article
- [Treatment resistance in anxiety disorders-Definition and treatment options].Der Nervenarzt · 2024Review
- Common pitfalls, and how to avoid them, in child and adolescent psychopharmacology: Part I.Journal of psychopharmacology (Oxford, England) · 2024Review
- Admixture Analysis of Age of Onset in Bipolar Disorder and Impact of Anxiety Comorbidity.Cureus · 2024Article
Corrections and comments
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Authors and funding
39 authors at 20 institutions in 14 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anxiety disorders are very prevalent and often persistent mental disorders, with a considerable rate of treatment resistance which requires regulatory clinical trials of innovative therapeutic interventions. However, an explicit definition of treatment-resistant anxiety disorders (TR-AD) informing such trials is currently lacking. We used a Delphi method-based consensus approach to provide internationally agreed, consistent and clinically useful operational criteria for TR-AD in adults. Following a summary of the current state of knowledge based on international guidelines and an available systematic review, a survey of free-text responses to a 29-item questionnaire on relevant aspects of TR-AD, and an online consensus meeting, a panel of 36 multidisciplinary international experts and stakeholders voted anonymously on written statements in three survey rounds. Consensus was defined as ≥75% of the panel agreeing with a statement. The panel agreed on a set of 14 recommendations for the definition of TR-AD, providing detailed operational criteria for resistance to pharmacological and/or psychotherapeutic treatment, as well as a potential staging model. The panel also evaluated further aspects regarding epidemiological subgroups, comorbidities and biographical factors, the terminology of TR-AD vs. "difficult-to-treat" anxiety disorders, preferences and attitudes of persons with these disorders, and future research directions. This Delphi method-based consensus on operational criteria for TR-AD is expected to serve as a systematic, consistent and practical clinical guideline to aid in designing future mechanistic studies and facilitate clinical trials for regulatory purposes. This effort could ultimately lead to the development of more effective evidence-based stepped-care treatment algorithms for patients with anxiety disorders.
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