A cognitive dysfunction in anxiety and its amelioration by effective treatment with SSRIs

There is extensive research suggesting an abnormal selective attention to threat in anxiety disorders. We assessed the processing of emotional cognitions of physical anxiety, psycho-social fears, depression and positive affect in a cohort of 15 patients with active anxiety disorder (mostly panic) in comparison with a group of 15 depressed patients and 15 recovered panic patients after treatment with antidepressants (all selective serotonin re-uptake inhibitors) and an age- and sex-matched normal control group. Anxious patients showed delayed processing of emotional words (both negative and positive) compared with depressed patients. The successfully treated group showed no such interference and their responses were indistinguishable from controls. It would therefore appear that anxious patients (panic and generalized anxiety disorder) are affected primarily (but not exclusively) by themes of self-harm and psycho-social fears, and that this cognitive dysfunction in pathological anxiety is a state rather than trait feature of the condition, which is responsive to pharmacological intervention.