Anxiety

Anxiety Disorder

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Anxiety Disorder

  • Epidemiology
  1. Anxiety Disorder Incidence (U.S.): 16%
  2. Family physicians treat 90% of anxiety patients
    1. Refer <10% of patients to psychiatry
  3. Elderly have lower Incidence of anxiety
    1. Elderly women more affected than men
    2. Often associated with depression
  • Pathophysiology
  1. Hyperarousal state
    1. Those with anxiety perceive a higher risk or fear in low risk situations
    2. Specific CNS circuits are activated with fear or noxious stimuli
  2. Begins in Brainstem reticular formation
    1. Locus Ceruleus (Secretes Norepinephrine)
    2. Dorsal and medial raphe nuclei (Secretes Serotonin)
  • Symptoms
  1. See Anxiety Symptoms
  2. Excessive Worry
  3. May affect relationships
  1. Standard Studies
    1. Serum Chemistry profile
      1. Serum Glucose
      2. Serum Calcium
      3. Serum Phosphate
    2. Thyroid Stimulating Hormone (TSH)
    3. Urine Drug Screen
  2. Studies if specifically indicated
    1. Serum Cortisol
    2. Urine Catecholamines
  1. Standard Studies
    1. Electrocardiogram
  2. Studies if specifically indicated
    1. Electroencephalogram (EEG)
    2. Vestibular testing
    3. Echocardiography
  • Evaluation