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Generalized Anxiety Disorder

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  1. Epidemiology
    1. Most common Anxiety Disorder
    2. Adult Prevalence: 2 to 8% per year
    3. Onset peaks in ages 20 to 40 years (least common over age 60 years)
    4. Women are more than twice as likely to be diagnosed with anxiety over lifetime
  2. Symptoms: Topics for Excessive Worry
    1. Children
      1. School performance
      2. Sports performance
      3. Catastrophic events (e.g. earthquake, nuclear war)
    2. College students
      1. Academic performance
      2. Relationships
    3. Adults
      1. Children's well-being
      2. Illness or injury
      3. Family and other relationships
      4. Occupational and financial concerns
    4. Elderly
      1. Health
      2. Social relationships
      3. Finances
  3. Symptoms: Physical
    1. See Anxiety Symptoms
  4. Symptoms: Avoidance behaviors
    1. Avoidance of activities may be subtle
    2. Limited interpersonal relationships
    3. Procrastination
    4. Non-assertive in new situations
  5. Diagnosis: Diagnostic Criteria (DSM IV)
    1. Excessive anxiety and worry for 6 months on most days
    2. Involves two or more life circumstances
    3. Anxiety or worry is difficult to control
    4. Associated symptoms (3 present in adult, 1 in child)
      1. Restless
      2. Fatigue
      3. Difficult concentration
      4. Irritable
      5. Muscle tension
      6. Sleep disturbance
    5. Impaired social or occupational functioning or distress
    6. No Anxiety Secondary Cause
      1. Not related to other psychiatric illness
        1. See Differential Diagnosis below
      2. Not related to underlying medical condition
      3. Not related to Substance Abuse
  6. Diagnosis: Scales
    1. Generalized Anxiety Disorder Scale (GAD-7)
    2. Hamilton Anxiety Scale (HAM-A)
    3. Zung Self Rating Scale for Anxiety
    4. Beck Anxiety Scale
  7. Differential Diagnosis
    1. See Anxiety Secondary Causes
    2. Anxiety Adjustment Disorder
    3. Major Depression
    4. Other Anxiety Disorder
    5. Personality Disorder (Anxiety Cluster)
  8. Management
    1. See Anxiety Non-pharmacologic Management
    2. See Anxiety Medications
  9. Prognosis: Predictors of better outcomes
    1. Lower anxiety level
    2. Lower demoralization level
    3. Higher level of Major Depression at presentation
  10. References
    1. APA (1994) DSM IV, APA, p. 432-6
    2. Derogatis (1989) Anxiety and Depressive Disorders, p.42
    3. Kroenke (2007) Ann Intern Med 146(5):317
    4. Wittchen (2002) J Clin Psychiatry 63:24
    5. Zal (1995) Fam Prac Recert 17(10):17

Anxiety Disorders (C0003469)

Definition (MSH)Persistent and disabling ANXIETY.
Definition (CSP)general term for the group of specific, anxiety-related, avoidance- prone disorders listed as NTs.
ConceptsMental or Behavioral Dysfunction (T048)
MSHD001008
EnglishANXIETY DIS, Anxiety disorder, Anxiety Disorders
Spanishtrastorno de ansiedad
Parent ConceptsMental disorders (C0004936), cancer psychosocial effects (C0280957), [X]Other anxiety disorders (C0349232), Ambiguous concept (C1274012)
SourcesAOD, CSP, LNC, MSH, MTH, NCI, NDFRT, OMIM, PDQ, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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