Anxiety Disorders: Sex Differences in Prevalence, Degree, and Background, But Gender-Neutral Treatment

Background: Anxiety disorders are more prevalent among women than among men. Objective: The aim of this paper was to investigate to what degree current psychological theories and treatment of anxiety disorders incorporate sex and gender considerations. Methods: Relevant English, Dutch, German, or French empirical articles published until November 2006 were identified using the PsycINFO and PubMed databases as well as manual searches. The following search terms were used: anxiety disorders and sex differences, anxiety disorders and gender, anxiety disorders and women, anxiety disorders and men; combinations of these terms were used with prevalence, phenotypes, treatment, and therapy. In addition to all the aforementioned combinations, we replaced anxiety disorders with agoraphobia, panic disorder, social phobia, specific phobia, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, and generalized anxiety disorder. Results: Whereas widespread attention has been paid to sex differences in the prevalence of anxiety disorders and their possible origins, scant attention has been given to these differences in terms of treatment. Conclusions: Prevention and treatment of anxiety disorders might be more effective if the available knowledge about sex and gender specificity was implemented. Concomitantly, treatment effect studies could be improved by greater consideration of sex and gender throughout the research process. More fundamental research is needed regarding the relationship between sex, gender, and anxiety disorders, particularly in association with other mental disorders that have an unequal prevalence between the sexes.