The anxiety state.

The term anxiety state attained notoriety in the recent war, as shell shock did in days gone by. Each came to be used casually as a label for practically every form of mental disability and for other conditions as well. This had serious results in the I9I4-I8 war, as many patients, being wrongly diagnosed, were wrongly treated. The aftermath was seen in the heavy burden of pensions with its inevitable concomitant of invalidism. Fortunately this was not repeated in the last war as psychiatry was taken seriously in the Services. The civil mental health service of the country is, however, far from adequate. There is a shortage of trained psychiatrists, a shortage of in-patient *facilities and a shortage of social workers. Consequently it falls to the general practitioner to diagnose, manage, and perhaps also to treat many psychoneurotic patients. At least half of this group will be sufferers from the genuine anxiety state. It is necessary therefore to use this term with care, otherwise treatment will be haphazard, prolonged, and disappointing to the patient and to the physician. This can only be done when there is a clear picture in the mind of what an anxiety state "looks like" clinically; and it is the purpose of this paper to draw the outlines of such a picture.