Generalized anxiety disorder (GAD) is characterized by excessive and persistent worrying about many things in daily life to a degree that it impacts daily function. It typically presents as anxiety that is difficult to control and causes significant distress or impairment. Patients often present with complaints of apprehensiveness, irritability, muscle tension, sleeplessness, and fatigue.
The reported estimated prevalence of GAD is 0.9% among adolescents and 2.9% among adults. Approximately one-third of the risk for developing GAD is attributable to genetic predisposition. It is common to have first-degree relatives with a number of anxiety and mood disorders. GAD is more commonly diagnosed among women than men. Patients often begin experiencing increasing worry in their youth and develop more severe and persistent symptoms later in life, often in their 20s and 30s.
GAD is distinguished from other anxiety disorders by longstanding, general worry that spans across multiple aspects of life and the lack of a specific trigger or focused, singular concern. People with GAD may also present with neuroticism and harm-avoidance behaviors. Individuals may exhibit features of obsessive-compulsive disorder (OCD) like counting, checking, and intrusive thoughts. But unlike OCD, these features in GAD are not time consuming or ritualized, and they tend to revolve around avoiding adverse outcomes in day-to-day activities rather than focusing on intrinsic fears.
GAD may co-occur with other disorders such as major depression, panic disorder, social phobia, and specific phobias. Patients with this disorder may have an increased risk of various general medical conditions.
Patients report increased worry about the people important to them, their health, events, work, school, or other tasks. GAD is strongly associated with restlessness, absentmindedness, difficulty concentrating, muscle tension, and poor sleep. Patients may also present with other somatic symptoms including headaches, gastrointestinal symptoms (eg, pain, nausea, diarrhea, constipation), or back pain.
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