Anxiety and Stress Disorders Research Unit

Director: Prof Dan Stein
E-mail: dan.stein@uct.ac.za

The Research Unit on Anxiety and Stress Disorders was established by the MRC in 1997. The Unit is located at the Department of Psychiatry of the University of Stellenbosch, in the northern suburbs of Cape Town, and researches the psychobiology and treatment of anxiety disorders, including obsessive-compulsive disorder (and spectrum conditions), panic disorder, posttraumatic stress disorder, and social anxiety disorder.

Community surveys have shown that anxiety disorders are the most common psychiatric disorders, causing extensive suffering and interference with work and social functioning. The anxiety disorders account for one third of all costs of mental illness, with two conditions (i.e., panic disorder and OCD) being amongst the 20 most disabling of all medical disorders.

Fortunately, there have been significant advances in the diagnosis, epidemiology, neurobiology, pharmacotherapy, and psychotherapy of anxiety disorders, as well as a recognition of the role that consumer advocacy can play in reducing stigma and encouraging early and appropriate treatment:

Diagnosis
The development of specific criteria for each of the different anxiety disorders has allowed reliable diagnosis of these disorders. This is important not only for identifying these conditions in clinical settings, but also for undertaking systematic research. Failure to diagnose anxiety disorders at a primary care level has been a significant problem in the past.

Epidemiology
Community surveys have shown that anxiety disorders are amongst the most common of the psychiatric disorders, and that they cause extensive suffering and interference with work and social function. The anxiety disorders account for one third of all costs of mental illness, with panic disorder being the eleventh and obsessive-compulsive disorder (OCD) the nineteenth most disabling of all medical disorders in 15 to 44 year-olds.

Neurobiology
Current methodologies have allowed the dissection of the specific neuroanatomical circuits and neurotransmitter systems involved in mediating the anxiety disorders. There are exciting parallels, for example, between the neurobiology of fear conditioning in animal models and that of clinical disorders. Furthermore, a range of psychopharmacological agents has been introduced for the treatment of anxiety disorders.

Psychotherapy
In recent years, a range of rigorous controlled research on the cognitive-behavioural psychotherapy of the anxiety disorders has been undertaken. Exposure techniques are particularly important in the successful treatment of a number of the anxiety disorders, and in the case of OCD have been shown to normalise dysfunctional brain activity.

Consumer Advocacy
In the past few decades, consumers with anxiety disorders have recognised the importance of establishing advocacy organisations to help increase awareness of these conditions, and to help fight discrimination against the mentally ill. Such groups have helped greatly to increase awareness of the anxiety disorders, and to encourage people to seek appropriate treatment.

Aims

1. To establish a unit focusing on anxiety disorders, including posttraumatic stress disorder;
2. To foster a multi-disciplinary biopsychosocial approach to the anxiety disorders;
3. To promote increased awareness of the anxiety disorders in the community;
4. To ensure capacity building of clinical and research skills in students and staff.