Anxiety
Generalized Anxiety Disorder
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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 Cause
s
Not primarily due to
Substance Abuse
Diagnosis
Scales
Generalized Anxiety Disorder Scale
(
GAD-7
)
PROM
IS 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 Cause
s
Major Depression
Personality Disorder
(Anxiety Cluster)
Other
Anxiety Disorder
Excessive Worry
due to
Panic Attack
s
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 Disorder
s, 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]
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