anxiety disorder

Importance Anxiety disorders and symptoms are prevalent and burdensome, and patients are most likely to seek treatment in primary care settings. However, anxiety is underdetected and undertreated. This narrative review details behavioral and pharmacological treatment options that are feasible and effective in primary care.

Observations Screening for anxiety is recommended for primary care patients younger than 65 years. Given that anxiety often involves somatic symptoms, assessment should include patient-reported symptom measures, clinical interview, physical examination, and appropriate laboratory tests. For subthreshold symptoms (those that do not meet diagnostic criteria for anxiety disorders) and adjustment-related anxiety, starting with self-help and behavioral treatment is recommended. When deciding between behavioral, pharmacological, or combined treatment for anxiety disorders, consider the presentation, patient preferences, potential adverse effects, and treatment history, and engage in shared decision-making. Cognitive-behavioral therapy (CBT) is the first-line behavioral treatment for anxiety. Brief CBT in primary care delivered by embedded behavioral health clinicians is effective. First-line pharmacotherapy for anxiety disorders includes several selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, which tend to be well tolerated without considerable long-term adverse effects. The main decision for pharmacological treatment is between a daily medication and a short-acting medication taken as needed for intermittent symptoms or while awaiting the effect of a daily medication. Benzodiazepines are not recommended due to risk of adverse effects, especially with long-term use. The Collaborative Care Management model, which involves collaboration between primary care clinicians, consulting psychiatrists, and care managers who monitor patient progress and provide behavioral treatment, improves anxiety outcomes compared to usual primary care.

Conclusions and Relevance Clinicians should recognize common anxiety presentations and understand how to differentiate between anxiety and other psychiatric or medical conditions. Referring patients to behavioral health specialists for CBT and/or prescribing recommended pharmacotherapy with Collaborative Care Management can help to reduce patient morbidity and improve functioning.

Author/s:

Robyn L. Shepardson, Jeffrey S. Khan, Katherine A. Buckheit

I’m Concerned About Anxiety—What Do I Need to Know?

Megan George — Tue, 05 May 2026 13:36:49 +0000

Date Added:

May 5, 2026

Journal/Publication:

JAMA

Publication Date:

May 4, 2026

URL:

I’m Concerned About Anxiety—What Do I Need to Know?

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.1001/jamainternmed.2026.0392

Keywords

PMID (1):

42081216

MeSH

Information for patients about the causes and management of anxiety. James W. Mold, MD, MPH

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What Is Anxiety?
Anxiety is a normal experience of worry or fear about something the body or mind interprets as threatening. Anxiety may show up in your thoughts, emotions, body sensations, or behaviors (like worrying, feeling nervous, sweaty palms, and avoiding certain situations).

Author/s:

Robyn L. Shepardson, Jeffrey S. Khan, Jennifer S. Funderburk