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Generalized anxiety disorder

Generalized anxiety disorder
Other namesGeneralised anxiety disorder
SpecialtyPsychiatry, psychology
SymptomsExcessive worry, restlessness, trouble sleeping, feeling tired, irritability, difficulty concentrating, muscle tension,[1] sweating, trembling[2]
ComplicationsParanoia, depression, heart disease, suicide[3]
Differential diagnosisPanic disorder, post-traumatic stress disorder, social anxiety disorder, borderline personality disorder, antisocial personality disorder, obsessive–compulsive disorder, specific phobia
TreatmentBehavioral therapy, metacognitive therapy, medications
MedicationAnxiolytics, Antidepressants
Frequency3–5% (lifetime prevalence)[4]

Generalized anxiety disorder (GAD) is an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities.[5] Worry often interferes with daily functioning. Individuals with GAD are often overly concerned about everyday matters such as health, finances, death, family, relationship concerns, or work difficulties.[6][7] Symptoms may include excessive worry, restlessness, trouble sleeping, exhaustion, irritability, sweating, and trembling.[2]

Symptoms must be consistent and ongoing, persisting at least six months for a formal diagnosis.[5][6] Individuals with GAD often have other disorders including other psychiatric disorders, substance use disorder, or obesity, and may have a history of trauma or family with GAD.[8] Clinicians use screening tools such as the GAD-7 and GAD-2 questionnaires to determine if individuals may have GAD and warrant formal evaluation for the disorder. In addition, screening tools may enable clinicians to evaluate the severity of GAD symptoms.[9][10]

Treatment includes types of psychotherapy and pharmacological intervention.[11][8] CBT and selective serotonin reuptake inhibitors (SSRIs) are first-line psychological and pharmacological treatments; other options include serotonin–norepinephrine reuptake inhibitors (SNRIs). In more severe, last resort cases, benzodiazepines, though not as first-line drugs as benzodiazepines are frequently abused and habit forming. In Europe, pregabalin is also used.[12] The positive effects (if any) of complementary and alternative medications (CAMs), exercise, therapeutic massage and other interventions have been studied.[13]

  1. ^ American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington: American Psychiatric Association. doi:10.1176/appi.books.9780890425596. ISBN 978-0-89042-555-8.
  2. ^ a b "Generalized Anxiety Disorder: When Worry Gets Out of Control". NIMH. Retrieved 30 May 2019.
  3. ^ DeMartini J, Patel G, Fancher TL (2 April 2019). "Generalized Anxiety Disorder". Annals of Internal Medicine. 170 (7): ITC49 – ITC64. doi:10.7326/AITC201904020. PMID 30934083. S2CID 91187957.
  4. ^ Craske MG, Stein MB (24 June 2016). "Anxiety". The Lancet. 388 (10063): 3048–3059. doi:10.1016/S0140-6736(16)30381-6. PMID 27349358. S2CID 208789585.
  5. ^ a b Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington, D.C.: American Psychiatric Association. 2013. p. 222. ISBN 978-0-89042-554-1.
  6. ^ a b "What Is Generalized Anxiety Disorder?", National Institute of Mental Health. Accessed 28 May 2008.
  7. ^ Torpy JM, Burke AE, Golub RM (2011). "Generalized Anxiety Disorder". JAMA. 305 (5): 522. doi:10.1001/jama.305.5.522. PMID 21285432.
  8. ^ a b Stern TA (13 February 2015). "Anxiety Disorders (chapter 32)". Massachusetts General Hospital comprehensive clinical psychiatry. Massachusetts General Hospital (Second ed.). London: Elsevier. ISBN 978-0-323-32899-9. OCLC 905232521.
  9. ^ Spitzer RL, Kroenke K, Williams JB, Löwe B (2006). "A Brief Measure for Assessing Generalized Anxiety Disorder". Archives of Internal Medicine. 166 (10): 1092–7. doi:10.1001/archinte.166.10.1092. PMID 16717171.
  10. ^ Schalet BD, Cook KF, Choi SW, Cella D (January 2014). "Establishing a common metric for self-reported anxiety: linking the MASQ, PANAS, and GAD-7 to PROMIS Anxiety". Journal of Anxiety Disorders. 28 (1): 88–96. doi:10.1016/j.janxdis.2013.11.006. ISSN 1873-7897. PMC 4046852. PMID 24508596.
  11. ^ Patel G, Fancher TL (2013-12-03). "In the clinic. Generalized anxiety disorder". Annals of Internal Medicine. 159 (11): ITC6–1, ITC6–2, ITC6-3, ITC6-4, ITC6-5, ITC6-6, ITC6-7, ITC6-8, ITC6-9, ITC6-10, ITC6-11, quiz ITC6-12. doi:10.7326/0003-4819-159-11-201312030-01006. ISSN 1539-3704. PMID 24297210. S2CID 42889106.
  12. ^ European Medicines Agency. EPAR summary for the public (Lyrica/pregabalin) EMA/229012/2010.
  13. ^ Barić H, Đorđević V, Cerovečki I, Trkulja V (March 2018). "Complementary and Alternative Medicine Treatments for Generalized Anxiety Disorder: Systematic Review and Meta-analysis of Randomized Controlled Trials". Advances in Therapy. 35 (3): 261–288. doi:10.1007/s12325-018-0680-6. ISSN 0741-238X. PMID 29508154. S2CID 3939726.

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