Materiały źródłowe

• #1 Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0501/p617.html

  Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States, and they can negatively impact a patient’s quality of life and disrupt important activities of daily living. Evidence suggests that the rates of missed diagnoses and misdiagnosis of GAD and PD are high, with symptoms often ascribed to physical causes. Diagnosing GAD and PD requires a broad differential and caution to identify confounding variables and comorbid conditions. Screening and monitoring tools can be used to help make the diagnosis and monitor response to therapy. The GAD-7 and the Severity Measure for Panic Disorder are free diagnostic tools. […] The hallmark of GAD is excessive, out-of-control worry, and PD is characterized by recurrent and unexpected panic attacks. Both conditions can negatively impact a patient’s quality of life and disrupt important activities of daily living. The rates of missed diagnoses and misdiagnosis of GAD and PD are high, with symptoms often ascribed to physical causes.

• #2 Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0501/p617.html

  A number of scales are available to establish diagnosis and assess severity. The GAD-7 has been validated as a diagnostic tool and a severity assessment scale, with a score of 10 or more having good diagnostic sensitivity and specificity. Greater GAD-7 scores correlate with more functional impairment. […] PD is characterized by episodic, unexpected panic attacks that occur without a clear trigger. Panic attacks are defined by the rapid onset of intense fear (typically peaking within about 10 minutes) with at least four of the physical and psychological symptoms in the DSM-5 diagnostic criteria. Another requirement for the diagnosis of PD is that the patient worries about further attacks or modifies his or her behavior in maladaptive ways to avoid them. […] When evaluating a patient for a suspected anxiety disorder, it is important to exclude medical conditions with similar presentations. Complicating the diagnosis of GAD and PD is that many conditions in the differential diagnosis are also common comorbidities. Additionally, many patients with GAD or PD meet criteria for other psychiatric disorders, including major depressive disorder and social phobia.

• #3 Generalized Anxiety Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441870/

  Generalized anxiety disorder is a mental health disorder that produces fear, worry, and a constant feeling of being overwhelmed. It is characterized by excessive, persistent, and unrealistic worry about everyday things. […] Generalized anxiety disorder is characterized by persistent, excessive, and unrealistic worry about everyday things. This worry could be multifaceted, including financial, family, health, and future concerns. It is excessive, difficult to control, and is often accompanied by many nonspecific psychological and physical symptoms. Excessive worry is the central feature of generalized anxiety disorder. […] Diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) include the following: Excessive anxiety and worry for at least 6 months, Difficulty controlling the worrying, The anxiety is associated with 3 or more of the below symptoms for at least 6 months: Restlessness, feeling keyed up or on edge, Being easily fatigued, Difficulty in concentrating or mind going blank, irritability, Muscle tension, Sleep disturbance, Irritability, The anxiety results in significant distress or impairment in social and occupational areas, The anxiety is not attributable to any physical cause.

• #4 Table 3.15, DSM-IV to DSM-5 Generalized Anxiety Disorder Comparison – Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t15/

  DSM-IV to DSM-5 Generalized Anxiety Disorder Comparison. A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). B. The person finds it difficult to control the worry. C. The anxiety and worry are associated with three or more of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months). D. The focus of the anxiety and worry is not confined to features of an Axis I disorder (e.g., the anxiety or worry is not about having a panic attack [as in panic disorder], being embarrassed in public [as in social phobia], being contaminated [as in obsessive-compulsive disorder] being away from home or close relatives [as in separation anxiety disorder], gaining weight [as in anorexia Nervosa], or having a serious illness [as in hypochondriasis]), and the anxiety and worry do not occur exclusively during posttraumatic stress disorder. E. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. F. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a mood disorder, a psychotic disorder, or a pervasive developmental disorder. […] The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).

• #5 Exploring anxiety: 4.2 Diagnostic criteria for generalised anxiety disorder and panic disorder | OpenLearn – Open University

  https://www.open.edu/openlearn/science-maths-technology/exploring-anxiety/content-section-4.2

  A.Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). […] B.The individual finds it difficult to control the worry. […] C.The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months): […] D.The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. […] E.The disturbance is not attributable to the physiological effects of a substance (e.g. a drug of abuse, a medication) or another medical condition (e.g. hyperthyroidism). […] F.The disturbance is not better explained by another mental disorder (e.g. anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in post-traumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder).

• #6 Generalized Anxiety Disorder (GAD) DSM-5 300.02 (F41.1)

  https://www.theravive.com/therapedia/generalized-anxiety-disorder-(gad)-dsm–5-300.02-(f41.1)

  Generalized Anxiety Disorder (GAD) find themselves extremely worried about these sorts of things, as well as many other issues, even when there may be little or no reason to worry. […] The primary symptom is not anxiety, but rather pain or a difficulty in sleeping. Since the diagnosis is so often incorrect, many patients with GAD do not receive proper treatment. […] All of the below features must be present in order to make a proper diagnosis of GAD: Excessive anxiety and worry, occurring more days than not for at least 6 months, concerning a number of events; The individual finds it difficult to control the worry; The anxiety and worry are associated with at least three of the following six symptoms (only one item required in children): Restlessness, feeling keyed up or on edge. Being easily fatigued Difficulty concentrating Irritability Muscle tension Sleep disturbance The anxiety, worry or physical symptoms cause clinically significant distress or impairment in important areas of functioning; The disturbance is not due to the physiological effects of a substance or medical condition; The disturbance is not better explained by another medical disorder.

• #7 Generalized Anxiety Disorder (GAD): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23940-generalized-anxiety-disorder-gad

  Generalized anxiety disorder (GAD) is a mental health condition that causes fear, worry and a constant feeling of being overwhelmed. Its characterized by excessive, frequent and unrealistic worry about everyday things, such as job responsibilities, health or chores. GAD is one of several anxiety disorders. […] Healthcare providers and mental health professionals use the criteria in the Diagnostic and Statistical Manual of Mental Disorders to diagnose generalized anxiety disorder. The criteria include: Excessive anxiety and worry for at least six months. Difficulty controlling the worrying. The anxiety results in significant distress or impairs daily functioning. The anxiety isn’t due to a physical cause (such as thyroid issues or substance use). […] If you think you or your child has GAD, it’s important to talk to a healthcare provider or a mental health professional, such as a psychologist. A healthcare provider will perform a physical exam and may order some tests to make sure there are no physical medical conditions or substances that are causing your symptoms.

• #8 Diagnosing Anxiety Disorders | NYU Langone Health

  https://nyulangone.org/conditions/anxiety-disorders/diagnosis

  NYU Langone specialists offer expert diagnosis of anxiety disorders, which are common mental health conditions that can interfere with daily activities, affecting your performance at work and school as well as your relationships. […] To diagnose an anxiety disorder, a doctor performs a physical exam, asks about your symptoms, and recommends a blood test, which helps the doctor determine if another condition, such as hypothyroidism, may be causing your symptoms. […] If the doctor does not find an underlying cause of the symptoms, he or she performs a psychological evaluation. […] During a psychological evaluation, a specialist asks if you have a family history of an anxiety disorder or depression. […] After the specialist assesses your symptoms and family history, he or she conducts a feedback session, during which you and the doctor discuss the diagnosis and most appropriate treatment options.

• #9 Anxiety Disorder Diagnosis: Tests, Screening, and Criteria

  https://www.verywellhealth.com/anxiety-disorder-diagnosis-5114303

  Your healthcare provider may also use the Generalized Anxiety Disorder Assessment (GAD-7) during diagnosis. […] The GAD-7 is a questionnaire that ranks your answers on a scale of zero to three. The questions focus on over the last two weeks how often you have been bothered by symptoms that might reflect GAD. Your healthcare provider adds up the answers to the seven questions to determine if you have GAD and its severity. […] Although there are no specific laboratory tests that can diagnose GAD, your healthcare provider may order some to rule out the possibility of another medical condition causing your symptoms. […] It is possible for certain medications and medical conditions to cause symptoms that can be similar to GAD. Make sure you share all of the vitamins, herbs, prescriptions, and OTC medications you take with your healthcare provider.

• #10 Generalised anxiety disorder – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/120

  Generalised anxiety disorder (GAD) is a common condition defined as chronic, excessive worry for at least 6 months that causes distress or impairment, and is hard to control. […] At least three key symptoms out of a possible six are required to make a diagnosis of GAD in adults according to the Diagnostic and Statistical Manual of mental disorders, fifth edition, text revision (DSM-5-TR) criteria. […] It is in part a diagnosis of exclusion: physical health conditions, other mental health disorders, and medications or other substances should be ruled out as a primary cause. […] Physical examination and laboratory studies are generally normal if no co-existing physical or mental health conditions or substance misuse issues exist. […] Generalised anxiety disorder (GAD) is defined as at least 6 months of excessive worry about everyday issues that is disproportionate to any inherent risk, causing distress or impairment.

• #11 Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0501/p617.html

  A number of scales are available to establish diagnosis and assess severity. The GAD-7 has been validated as a diagnostic tool and a severity assessment scale, with a score of 10 or more having good diagnostic sensitivity and specificity. Greater GAD-7 scores correlate with more functional impairment. […] PD is characterized by episodic, unexpected panic attacks that occur without a clear trigger. Panic attacks are defined by the rapid onset of intense fear (typically peaking within about 10 minutes) with at least four of the physical and psychological symptoms in the DSM-5 diagnostic criteria. Another requirement for the diagnosis of PD is that the patient worries about further attacks or modifies his or her behavior in maladaptive ways to avoid them. […] When evaluating a patient for a suspected anxiety disorder, it is important to exclude medical conditions with similar presentations. Complicating the diagnosis of GAD and PD is that many conditions in the differential diagnosis are also common comorbidities. Additionally, many patients with GAD or PD meet criteria for other psychiatric disorders, including major depressive disorder and social phobia.

• #12 Generalized Anxiety Disorder 7-item (GAD-7) – Mental Health Screening – National HIV Curriculum

  https://www.hiv.uw.edu/page/mental-health-screening/gad-7

  The Generalized Anxiety Disorder 7-item (GAD-7) is a easy to perform initial screening tool for generalized anxiety disorder. […] When screening for anxiety disorders, a score of 8 or greater represents a reasonable cut-point for identifying probable cases of generalized anxiety disorder; further diagnostic assessment is warranted to determine the presence and type of anxiety disorder. Using a cut-off of 8 the GAD-7 has a sensitivity of 92% and specificity of 76% for diagnosis generalized anxiety disorder. […] Although designed as a screening tool for generalized anxiety, the GAD-7 is also performs reasonably well as a screening tool for three other common anxiety disorders: Panic Disorder, Social Anxiety Disorder, and Posttraumatic Stress Disorder.

• #13 GAD7 Anxiety Test Questionnaire

  https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7

  This easy-to-use self-administered patient questionnaire is used as a screening tool and severity measure for generalised anxiety disorder (GAD). […] Using the threshold score of 10, the GAD-7 has a sensitivity of 89% and a specificity of 82% for GAD. […] The GAD-7 scale was accurate for diagnosing generalised anxiety disorder.

• #14 Generalised Anxiety Disorder Assessment (GAD-7)

  https://www.corc.uk.net/outcome-experience-measures/directory-of-outcome-measures/generalised-anxiety-disorder-assessment-gad-7/

  The Generalised Anxiety Disorder Assessment (GAD-7) is a seven-item instrument that is used to measure or assess the severity of generalised anxiety disorder (GAD). Each item asks the individual to rate the severity of his or her symptoms over the past two weeks. Response options include not at all, several days, more than half the days and nearly every day. […] The GAD-7 has been validated for primary care patients, general population, and adolescents with GAD (Mossman et al., 2018, found that GAD-7 scores may be used to assess anxiety symptoms and to differentiate between mild and moderate GAD in adolescents). […] The GAD-7 score is calculated by assigning scores of 0, 1, 2, and 3, to the response categories of not at all, several days, more than half the days, and nearly every day, respectively, and then adding together the scores for the seven questions.

• #15 Generalized Anxiety Disorder 7-item (GAD-7) – Mental Health Screening – National HIV Curriculum

  https://www.hiv.uw.edu/page/mental-health-screening/gad-7

  The Generalized Anxiety Disorder 7-item (GAD-7) is a easy to perform initial screening tool for generalized anxiety disorder. […] When screening for anxiety disorders, a score of 8 or greater represents a reasonable cut-point for identifying probable cases of generalized anxiety disorder; further diagnostic assessment is warranted to determine the presence and type of anxiety disorder. Using a cut-off of 8 the GAD-7 has a sensitivity of 92% and specificity of 76% for diagnosis generalized anxiety disorder. […] Although designed as a screening tool for generalized anxiety, the GAD-7 is also performs reasonably well as a screening tool for three other common anxiety disorders: Panic Disorder, Social Anxiety Disorder, and Posttraumatic Stress Disorder.

• #16 Generalized Anxiety Disorder 2-item (GAD-2) – Mental Health Screening – National HIV Curriculum

  https://www.hiv.uw.edu/page/mental-health-screening/gad-2

  The Generalized Anxiety Disorder 2-item (GAD-2) is a very brief and easy to perform initial screening tool for generalized anxiety disorder. […] A score of 3 points is the preferred cut-off for identifying possible cases and in which further diagnostic evaluation for generalized anxiety disorder is warranted. […] Using a cut-off of 3 the GAD-2 has a sensitivity of 86% and specificity of 83% for diagnosis generalized anxiety disorder.

• #17 Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0501/p617.html

  A number of scales are available to establish diagnosis and assess severity. The GAD-7 has been validated as a diagnostic tool and a severity assessment scale, with a score of 10 or more having good diagnostic sensitivity and specificity. Greater GAD-7 scores correlate with more functional impairment. […] PD is characterized by episodic, unexpected panic attacks that occur without a clear trigger. Panic attacks are defined by the rapid onset of intense fear (typically peaking within about 10 minutes) with at least four of the physical and psychological symptoms in the DSM-5 diagnostic criteria. Another requirement for the diagnosis of PD is that the patient worries about further attacks or modifies his or her behavior in maladaptive ways to avoid them. […] When evaluating a patient for a suspected anxiety disorder, it is important to exclude medical conditions with similar presentations. Complicating the diagnosis of GAD and PD is that many conditions in the differential diagnosis are also common comorbidities. Additionally, many patients with GAD or PD meet criteria for other psychiatric disorders, including major depressive disorder and social phobia.

• #18 Generalized Anxiety Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441870/

  The Generalized Anxiety Disorder 7-Item (GAD-7) Questionnaire is a screening tool that can also be used to monitor patients with generalized anxiety disorder. […] The 2 main treatments for generalized anxiety disorder are cognitive behavioral therapy and medications. Patients may benefit most from a combination of the two. […] The first-line agents are SSRI and SNRI classes, with a response rate of 30% to 50%. […] The differential diagnoses for generalized anxiety disorder include the following: Hyperthyroidism, Pheochromocytoma, Chronic obstructive pulmonary disease, Transient ischemic attack, Epilepsy, Bipolar disorder, Use of caffeine, decongestants, and albuterol. […] The prognosis for patients with generalized anxiety disorder is guarded. Many patients are not compliant with medications because of cost and adverse effects. Relapses are common, and patients often search for physicians who comply with their needs. […] Overall, anxiety disorders are underdiagnosed and undertreated. When left untreated, anxiety disorders often lead to severe depression and abuse of drugs and alcohol.

• #19 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  The symptoms of GAD and PD can suggest medical diagnoses, including hyperthyroidism, arrhythmias, asthma, chronic obstructive pulmonary disease, certain medication use or withdrawal, and substance use or withdrawal. […] GAD and PD commonly occur with other psychiatric conditions, including major depressive episodes, manic-hypomanic episodes, dysthymia, and substance use disorder. […] There is insufficient evidence to support universal screening for GAD or PD in adults at this time; however, the U.S. Preventive Services Task Force is updating guidelines regarding screening for anxiety, suicidality, and depression. […] Evaluation for GAD should be considered for patients who express anxiety, pervasive worry, or recurrent somatic symptoms not related to an underlying physical condition. […] The GAD-2 and GAD-7 are two-item and seven-item validated screening tools for GAD. […] The Patient Health Questionnaire for PD is the most accurate screening tool for PD in patients expressing sudden episodes of anxiety or fear.

• #20 Generalized anxiety disorder differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Generalized_anxiety_disorder_differential_diagnosis

  The differential diagnosis in generalized anxiety disorder is similar to that of panic disorder. It is important to rule out drug-induced conditions. The mental status examination should take in consideration the possibility of schizophrenia, obsessive-compulsive disorder, major depressive disorder, and both specific and social phobias. […] According to DSM V, the following criteria should be present to fit the diagnosis of generalized anxiety disorder: The presence of sense of apprehension or fear toward certain activities for most of the days for at least 6 months, Difficulty to control the apprehension, Associated restless, fatigue, irritability, difficult concentration, muscle tension or sleep disturbance (only one of these manifestations), The anxiety or the physical manifestations must affect the social and the daily life of the patient, Exclusion of another medical condition or the effect of another administered substance, Exclusion of another mental disorder causing the symptoms.

• #21 Generalized Anxiety Disorder (GAD) DSM-5 300.02 (F41.1)

  https://www.theravive.com/therapedia/generalized-anxiety-disorder-(gad)-dsm–5-300.02-(f41.1)

  Generalized Anxiety Disorder (GAD) find themselves extremely worried about these sorts of things, as well as many other issues, even when there may be little or no reason to worry. […] The primary symptom is not anxiety, but rather pain or a difficulty in sleeping. Since the diagnosis is so often incorrect, many patients with GAD do not receive proper treatment. […] All of the below features must be present in order to make a proper diagnosis of GAD: Excessive anxiety and worry, occurring more days than not for at least 6 months, concerning a number of events; The individual finds it difficult to control the worry; The anxiety and worry are associated with at least three of the following six symptoms (only one item required in children): Restlessness, feeling keyed up or on edge. Being easily fatigued Difficulty concentrating Irritability Muscle tension Sleep disturbance The anxiety, worry or physical symptoms cause clinically significant distress or impairment in important areas of functioning; The disturbance is not due to the physiological effects of a substance or medical condition; The disturbance is not better explained by another medical disorder.

• #22 Generalized Anxiety Disorder (GAD) – PsychDB

  https://www.psychdb.com/anxiety/gad

  The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. […] The disturbance is not attributable to the physiological effects of a substance (e.g. – a drug of abuse, a medication) or another medical condition (e.g. – hyperthyroidism). […] Generalized anxiety disorder may be overdiagnosed in children, and other mental disorders such as separation disorder, social anxiety disorder, and OCD should be explored first.

• #23 Generalised Anxiety Disorder – Diagnosis and Management

  https://psychscenehub.com/psychinsights/generalised-anxiety-disorder-diagnosis-and-management-2/

  Generalised anxiety disorder (GAD) is characterized by persistent feelings of fear and worry about everyday things that are difficult to control. […] The diagnosis of GAD consists of two main components: Excessive Worry and Persistent restlessness. […] DSM-5 diagnosis of GAD includes excessive anxiety and worry occurring more days than not for at least 6 months, about a number of events or activities. […] People with GAD seek reassurance to reduce immediate worry, avoid events that could have negative consequences and spend considerable time preparing for events to minimize worry. […] GAD is on average only diagnosed 10 years after onset at which point the patient has gone to the doctors due to comorbid issues such as panic disorder, depression, or chronic pain disorders. […] Therefore, all patients that are diagnosed with anxiety should be screened for depression as well.

• #24 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Generalized-Anxiety-Disorder-Diagnosis.aspx

  Persons with generalized anxiety disorder (GAD) often feel worried and anxious. These feelings are not confined to a specific time or situation but occur throughout the day. Generalized anxiety disorder can be an intense emotional state, which interrupts a persons day-to-day activities. It is difficult to diagnose this disorder, which is often confused with other mental conditions. […] There is no specific laboratory examination for the diagnosis of generalized anxiety disorder. The process starts with the observation of the affected person. The healthcare provider draws out the medical history and elicits the symptoms to see whether they are related to other medical conditions or fit the diagnosis of GAD. […] The major factor pointing to GAD is that a person is persistently worried about a variety of problems over a period of six months or more. These worries prevent the individual from pursuing normal daily occupations by causing severe mental stress. Moreover, if the person finds difficulties in maintaining control, suffers from severe worry and anxiety, and is not able to relax, it is clearly a sign of GAD.

• #25 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Generalized-Anxiety-Disorder-Diagnosis.aspx

  The mental healthcare provider should look for the baseline symptoms and classify them to identify what type of mental disorder they refer to. In this situation, it is necessary to be sure whether the person undergoes clinical distress. If any of these three symptoms occur for a period of six months at least, then the individual is identified as having generalized anxiety disorder. […] The underlying cause for the emergence of GAD should also be searched for earnestly. The healthcare provider must actively look for and apply necessary tests for other disorders that could cause or contribute to GAD. […] As mentioned earlier, a generalized anxiety disorder may be difficult to diagnose, as it does not have noticeable or dramatic symptoms as with other conditions. The major problem in diagnosing GAD is the generalized nature of the condition. There are no traceable incidents to draw one towards the diagnosis. The physical symptoms of GAD may resemble those of many other disorders like depression, panic disorder, and substance abuse. So the healthcare provider must analyze the primary factor that is responsible for the patients symptoms. […] Patients sometimes hesitate to share their emotions and feelings with mental health professionals. It is essential for the doctor to draw out the actual symptoms, so that the proper diagnosis is made to treat GAD appropriately.

• #26 Generalised Anxiety Disorder – Diagnosis and Management

  https://psychscenehub.com/psychinsights/generalised-anxiety-disorder-diagnosis-and-management-2/

  Generalised anxiety disorder (GAD) is characterized by persistent feelings of fear and worry about everyday things that are difficult to control. […] The diagnosis of GAD consists of two main components: Excessive Worry and Persistent restlessness. […] DSM-5 diagnosis of GAD includes excessive anxiety and worry occurring more days than not for at least 6 months, about a number of events or activities. […] People with GAD seek reassurance to reduce immediate worry, avoid events that could have negative consequences and spend considerable time preparing for events to minimize worry. […] GAD is on average only diagnosed 10 years after onset at which point the patient has gone to the doctors due to comorbid issues such as panic disorder, depression, or chronic pain disorders. […] Therefore, all patients that are diagnosed with anxiety should be screened for depression as well.

• #27 Tools for Assessing Generalized Anxiety Disorder

  https://www.psychiatrictimes.com/view/tools-assessing-generalized-anxiety-disorder

  Generalized anxiety disorder (GAD) is a chronic, impairing and highly comorbid psychiatric condition. A small but sufficient group of empirically supported instruments to assess the severity of GAD are now available. […] A diagnosis of GAD involves excessive anxiety and worry about a number of events or activities, which occur more days than not for at least six months. […] Accurate assessment of GAD and its severity by mental health and primary care clinicians is an increasingly important goal. […] Reliable diagnosis and assessment of disorder severity can guide the nature, frequency and duration of therapeutic interventions. […] Assessing the severity of GAD can be done quantitatively (e.g., a 0-10 rating scale), qualitatively (e.g., categorical classifications such as mild, moderate or severe), or with some combination of these approaches.

• #28 Tools for Assessing Generalized Anxiety Disorder

  https://www.psychiatrictimes.com/view/tools-assessing-generalized-anxiety-disorder

  A complementary way to assess the severity of GAD is to focus on the specific symptoms constituting the disorder. […] The Hamilton Anxiety Rating Scale (HAM-A) is a widely used interview measure designed to assess anxiety. […] Recently, Shear and colleagues have developed the Generalized Anxiety Disorder Severity Scale (GADSS). […] Self-report measures have the advantages of brevity, ease of administration and scoring, and a decreased demand on human resources. […] The Penn State Worry Questionnaire (PSWQ) measures a general trait-like tendency to worry excessively. […] Accurate detection, diagnosis and assessment of disorder severity can inform the clinician’s interventions and improve treatment effectiveness. […] A small but sufficient group of empirically supported instruments to assess the severity of GAD are now available and should be judiciously combined with one’s clinical acumen.

• #29 Generalized anxiety disorder in adults: Management – UpToDate

  https://www.uptodate.com/contents/generalized-anxiety-disorder-in-adults-management

  Generalized anxiety disorder (GAD) is characterized by excessive worry and anxiety that are difficult to control, cause significant distress and impairment, and occur on more days than not for at least six months. […] The disorder can be effectively treated with cognitive-behavioral therapy, medication, or a combination of the two modalities. […] Once a patient has been diagnosed with generalized anxiety disorder (GAD), the next step is to determine, based on clinical assessment of severity, extent of distress or impairment, and patient preference, whether treatment of the disorder is needed. The main objective of treatment is to reduce symptoms of anxiety and thereby improve functioning. […] If symptoms are worsening or if daily functioning is affected, we recommend treatment.

• #30 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  The symptoms of GAD and PD can suggest medical diagnoses, including hyperthyroidism, arrhythmias, asthma, chronic obstructive pulmonary disease, certain medication use or withdrawal, and substance use or withdrawal. […] GAD and PD commonly occur with other psychiatric conditions, including major depressive episodes, manic-hypomanic episodes, dysthymia, and substance use disorder. […] There is insufficient evidence to support universal screening for GAD or PD in adults at this time; however, the U.S. Preventive Services Task Force is updating guidelines regarding screening for anxiety, suicidality, and depression. […] Evaluation for GAD should be considered for patients who express anxiety, pervasive worry, or recurrent somatic symptoms not related to an underlying physical condition. […] The GAD-2 and GAD-7 are two-item and seven-item validated screening tools for GAD. […] The Patient Health Questionnaire for PD is the most accurate screening tool for PD in patients expressing sudden episodes of anxiety or fear.

• #31 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  The symptoms of GAD and PD can suggest medical diagnoses, including hyperthyroidism, arrhythmias, asthma, chronic obstructive pulmonary disease, certain medication use or withdrawal, and substance use or withdrawal. […] GAD and PD commonly occur with other psychiatric conditions, including major depressive episodes, manic-hypomanic episodes, dysthymia, and substance use disorder. […] There is insufficient evidence to support universal screening for GAD or PD in adults at this time; however, the U.S. Preventive Services Task Force is updating guidelines regarding screening for anxiety, suicidality, and depression. […] Evaluation for GAD should be considered for patients who express anxiety, pervasive worry, or recurrent somatic symptoms not related to an underlying physical condition. […] The GAD-2 and GAD-7 are two-item and seven-item validated screening tools for GAD. […] The Patient Health Questionnaire for PD is the most accurate screening tool for PD in patients expressing sudden episodes of anxiety or fear.

• #32 Generalized Anxiety Disorder: Symptoms and DSM-5 Diagnosis

  https://www.verywellmind.com/dsm-5-criteria-for-generalized-anxiety-disorder-1393147

  In order to give a diagnosis of GAD, these symptoms also must be unrelated to any other medical conditions and cannot be explained by a different mental disorder or by the effect of substance use, including prescription medication, alcohol, or recreational drugs. […] The U.S. Preventative Services Task Force recommends that all adults under the age of 65 get screened for anxiety symptoms during routine doctor visits. […] To give a differential diagnosis means to distinguish one condition from another when there are symptoms that overlap. […] There can be other behaviors and symptoms that can be present with anxiety. […] Sitting with a qualified professional to determine an accurate diagnosis is key.

• #33 Anxiety Disorders: Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/9536-anxiety-disorders

  Generalized anxiety disorder (GAD): This condition causes fear, worry and a constant feeling of being overwhelmed. Its characterized by excessive, frequent and unrealistic worry about everyday things, such as job responsibilities, health or chores. […] If you or your child are experiencing symptoms of an anxiety disorder, see a healthcare provider. Theyll start with a medical evaluation. Theyll do a physical exam and ask about your medical history, any medications youre taking and if any of your family members have been diagnosed with an anxiety disorder. […] A mental health professional, such as a psychologist or psychiatrist, will do an interview or survey, asking questions about your symptoms, sleeping habits and other behaviors. They use criteria in the American Psychiatric Associations DSM-5 to make diagnoses of anxiety disorders.

• #34 Generalized Anxiety Disorder Self-Test | Brain Therapy TMS

  https://braintherapytms.com/gad-7-self-test/

  Generalized Anxiety Disorder is diagnosed with a health screening by your physician or primary care provider. Depending on the symptoms, they may refer to either a psychiatrist or a psychologist. […] One of the most commonly used tests is the GAD-7, a diagnostic self-report scale that can tell the patient if the anxiety is mild, moderate, or severe. […] A medical professional may also perform other tests, especially when you are at risk for GAD.

• #35 Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0501/p617.html

  Medication or psychotherapy is a reasonable initial treatment option for GAD and PD. Some studies suggest that combining medication and psychotherapy may be more effective for patients with moderate to severe symptoms. […] Psychotherapy includes many different approaches, such as cognitive behavior therapy (CBT) and applied relaxation. CBT may use applied relaxation, exposure therapy, breathing, cognitive restructuring, or education. Psychotherapy is as effective as medication for GAD and PD. […] Successful treatment requires tailoring options to individuals and may often include a combination of modalities. Combined treatment with medications and psychotherapy reduces relapse even at two years.

• #36 Generalized Anxiety Disorder (GAD): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23940-generalized-anxiety-disorder-gad

  Generalized anxiety disorder is generally treated with psychotherapy (talk therapy), medication or both. […] Mental health professionals most often use cognitive behavioral therapy (CBT) specifically to help treat GAD. […] Your healthcare provider or psychiatrist may prescribe medication to treat GAD. Different types of medication include: Antidepressants: Healthcare providers commonly prescribe selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) antidepressants to treat depression, but they also can help treat the symptoms of GAD. […] There’s no known way to prevent generalized anxiety disorder, but many of its symptoms can be lessened with treatment. Seeking help as soon as symptoms appear can help decrease the disruptions to your life.

• #37 Generalized Anxiety Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441870/

  The Generalized Anxiety Disorder 7-Item (GAD-7) Questionnaire is a screening tool that can also be used to monitor patients with generalized anxiety disorder. […] The 2 main treatments for generalized anxiety disorder are cognitive behavioral therapy and medications. Patients may benefit most from a combination of the two. […] The first-line agents are SSRI and SNRI classes, with a response rate of 30% to 50%. […] The differential diagnoses for generalized anxiety disorder include the following: Hyperthyroidism, Pheochromocytoma, Chronic obstructive pulmonary disease, Transient ischemic attack, Epilepsy, Bipolar disorder, Use of caffeine, decongestants, and albuterol. […] The prognosis for patients with generalized anxiety disorder is guarded. Many patients are not compliant with medications because of cost and adverse effects. Relapses are common, and patients often search for physicians who comply with their needs. […] Overall, anxiety disorders are underdiagnosed and undertreated. When left untreated, anxiety disorders often lead to severe depression and abuse of drugs and alcohol.

• #38 Generalized Anxiety Disorder (GAD): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23940-generalized-anxiety-disorder-gad

  The prognosis (outlook) for generalized anxiety disorder can vary depending on how severe it is. In some cases, GAD is long-term (chronic) and difficult to treat. However, most people experience improvement in their symptoms with medicine and/or talk therapy. […] Generalized anxiety disorder (GAD) can make it difficult to get through the day. The good news is that several effective anxiety treatments are available, including talk therapy and medications. Talk to your healthcare provider to figure out your diagnosis and the best treatment plan.

• #39 Generalised anxiety disorder diagnosis – Mental Health UK

  https://mentalhealth-uk.org/help-and-information/conditions/generalised-anxiety-disorder/diagnosis/

  If your experience with anxiety is affecting your everyday life, you should make an appointment to speak with your GP. […] To be diagnosed with GAD, a mental health specialist will conduct an assessment against a specific validated criterion, such as the International Classification of Diseases 11th Revision (ICD-11) developed by the World Health Organisation. The assessment will look at the nature, duration and intensity of an individuals anxiety along with the symptoms being experienced. […] It may feel like your symptoms cannot improve, but treatment and recovery from generalised anxiety disorder is possible.

• #40 Against the Stream: Generalised anxiety disorder (GAD) – a redundant diagnosis | BJPsych Bulletin | Cambridge Core

  https://www.cambridge.org/core/journals/bjpsych-bulletin/article/against-the-stream-generalised-anxiety-disorder-gad-a-redundant-diagnosis/0334788B49ED4346CEAB62ED760E6010

  The diagnosis of generalised anxiety disorder is a distraction of no value. It is highly unreliable, co-occurring with many other disorders of firmer diagnostic status, and has intrinsic connections to personality dysfunction. It is argued that classification would be heartily relieved to rid itself of this unnecessary appendage and for the symptom of anxiety to remain as a descriptive term only. […] Generalised anxiety disorder (GAD) describes an excessive and disproportionate anxiety or worry about minor matters that would not trouble most people. […] It is a recurrent disorder and often lasts for many years. […] Each of the components of the diagnosis has been systematically stripped away, leaving an ill-defined core of excessive worry only, which makes the diagnosis so grossly comorbid as to be useless.

• #41 Against the Stream: Generalised anxiety disorder (GAD) – a redundant diagnosis | BJPsych Bulletin | Cambridge Core

  https://www.cambridge.org/core/journals/bjpsych-bulletin/article/against-the-stream-generalised-anxiety-disorder-gad-a-redundant-diagnosis/0334788B49ED4346CEAB62ED760E6010

  There is so much overlap between personality status and GAD that a strong case can be made for a condition called the general neurotic syndrome (or the general nervous syndrome for those who abhor the word neurotic), in which certain personality features such as obsessionality and dependence, as well as anxiousness, contribute to the biaxial diagnosis. […] Despite the valiant efforts of David Goldberg and several others, there has been great reluctance to accept mixed anxiety-depression as a full syndromal diagnosis in either the DSM or ICD classifications. If this was agreed, and it is becoming increasingly likely this will happen, the separate diagnosis of GAD would be weakened severely. […] In the recent field trials of DSM-5, the interrater reliability of GAD was 0.20, which the authors regard as questionable, but which most clinicians would regard as unacceptable.

• #42 Enhanced diagnostics for generalized anxiety disorder: leveraging differential channel and functional connectivity features based on frontal EEG signals | Scientific Reports

  https://www.nature.com/articles/s41598-024-73615-1

  Generalized Anxiety Disorder (GAD) is a chronic anxiety condition characterized by persistent excessive worry, anxiety, and fear. Current diagnostic practices primarily rely on clinicians subjective assessments and experience, highlighting a need for more objective and reliable methods. […] Currently, the diagnostic tools for GAD are relatively scarce, primarily relying on subjective scales and professional assessments based on the fifth edition Diagnostic and Statistical Manual of Mental Disorders. This method is influenced by the subjectivity of both patients and professional doctors, lacking objective and consistency, leading to high rates of misdiagnosis and incorrect diagnosis. […] Therefore, it is crucial to develop effective intelligent diagnostic technologies based on objective, practical, and reliable neurophysiological biomarkers.

• #43 Enhanced diagnostics for generalized anxiety disorder: leveraging differential channel and functional connectivity features based on frontal EEG signals | Scientific Reports

  https://www.nature.com/articles/s41598-024-73615-1

  Overall, the methodologies developed in this study offer accurate and practical identification strategies for the early screening and clinical diagnosis of GAD, offering the necessary theoretical and technical support for further enhancing the portability of EEG devices. […] The primary contributions of this paper are summarized as follows: Proposed a classification framework based on frontal 6-Channel EEG data: This study successfully classified GAD patients and HC using EEG data from only six frontal channels, demonstrating the effectiveness of using fewer channels for accurate classification. […] Developed a Differential Channel method: This study by introducing a differential channel approach based on the six frontal EEG channels, followed by the extraction of functional connectivity features that significantly improved classification accuracy, showcasing the advantages of this novelty method.

• #44 Anxiety Disorder Diagnosis: Tests, Screening, and Criteria

  https://www.verywellhealth.com/anxiety-disorder-diagnosis-5114303

  Even if you take this type of test, you will still need to see a healthcare provider to get a diagnosis and treatment. […] It is crucial not to wait before asking for help. Although it can be hard to seek out a diagnosis, it is the right decision. […] If you or a loved one is experiencing GAD, it is important to talk to your healthcare provider. Receiving the correct diagnosis is the first step on the path to wellness because understanding the mental health condition you have is important for getting the right treatment.

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