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Generalized Anxiety Disorder
Aka: Generalized Anxiety Disorder
- See Also
- Anxiety Disorder
- Anxiety Secondary Cause
- Anxiety Symptoms
- Obsessive Compulsive Disorder
- Body Dysmorphic Disorder
- Panic Disorder
- Social Anxiety Disorder (Social Phobia)
- Acute Stress Disorder
- Post-Traumatic Stress Disorder
- Excessive Worry
- Anxiety Non-pharmacologic Management
- Anxiety Pharmacologic Management
- Epidemiology
- Most common Anxiety Disorder
- Adult Prevalence
- Annual: 2 to 3% per year
- Lifetime: 7-8% in women, 4-5% in men
- Onset peaks in ages 20 to 40 years (least common over age 60 years)
- Women are more than twice as likely to be diagnosed with anxiety over lifetime
- Pathophysiology
- Dysregulation of worry
- Symptoms: Topics of Excessive Worry
- Children
- School performance
- Sports performance
- Catastrophic events (e.g. earthquake, nuclear war)
- College students
- Academic performance
- Relationships
- Adults
- Children's well-being
- Illness or injury
- Family and other relationships
- Occupational and financial concerns
- Elderly
- Health
- Social relationships
- Finances
- Symptoms: Physical
- See Anxiety Symptoms
- Excessive, overwhelming and uncontrolled worry
- Symptoms: Avoidance behaviors
- Avoidance of activities may be subtle
- Limited interpersonal relationships
- Procrastination
- Non-assertive in new situations
- Diagnosis: Diagnostic Criteria (DSM V)
- Excessive anxiety and worry for at least 6 months on most days
- Involves two or more life circumstances (e.g. home, work)
- Anxiety or worry is difficult to control
- Associated symptoms (3 present in adult, 1 in child)
- Restlessness or on edge
- Fatigue
- Difficult concentration
- Irritable
- Muscle tension
- Sleep disturbance
- Impaired social or occupational functioning or distress
- No Anxiety Secondary Cause
- Not primarily to other psychiatric illness
- See Differential Diagnosis below
- Not primarily due to underlying medical condition
- See Anxiety Secondary Causes
- Not primarily due to Substance Abuse
- Diagnosis: Scales
- Generalized Anxiety Disorder Scale (GAD-7)
- PROMIS Emotional Distress-Anxiety Short Form for adults
- Severity Measure for Generalized Anxiety Disorder - Adults
- Hamilton Anxiety Scale (HAM-A)
- Zung Self Rating Scale for Anxiety
- Beck Anxiety Scale
- Differential Diagnosis
- See Anxiety Secondary Causes
- Major Depression
- Personality Disorder (Anxiety Cluster)
- Other Anxiety Disorder
- Excessive Worry due to Panic Attacks
- Anxiety Adjustment Disorder
- Social Anxiety Disorder
- Obsessive Compulsive Disorder
- Posttraumatic Stress Disorder
- Other psychiatric conditions
- Eating Disorder (anxiety)
- Body Dysmorphic Disorder
- Management
- See Anxiety Non-pharmacologic Management
- See Anxiety Medications
- Prognosis: Predictors of better outcomes
- Lower anxiety level
- Lower demoralization level
- Higher level of Major Depression at presentation
- References
- APA (1994) DSM IV, APA, p. 432-6
- Derogatis (1989) Anxiety and Depressive Disorders, p.42
- Kroenke (2007) Ann Intern Med 146(5): 317-25 [PubMed]
- Locke (2015) Am Fam Physician 91(9): 617-24 [PubMed]
- Wittchen (2002) J Clin Psychiatry 63:24-34 [PubMed]
- Zal (1995) Fam Prac Recert 17(10): 17-32 [PubMed]