Generalized anxiety disorder
Alerts and Notices
Synopsis
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.
Related topic: Drug-induced anxiety
Codes
ICD10CM:F41.1 – Generalized anxiety disorder
SNOMEDCT:
21897009 – Generalized anxiety disorder
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Drug-induced anxiety
- Other anxiety disorders – social anxiety disorder, specific phobia, panic disorder, agoraphobia
- Obsessive-compulsive disorder
- Posttraumatic stress disorder
- Adjustment disorders
- Depressive disorders
- Bipolar disorders
- Psychotic disorders – schizophrenia, schizoaffective disorder, brief psychotic disorder
- Cluster C personality disorders – avoidant, dependent, obsessive-compulsive
- Paranoid personality disorder, a cluster A disorder
- Delirium
- Anxiety secondary to a medical disorder – pheochromocytoma, hyperthyroidism, irritable bowel syndrome, or acute coronary syndrome
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Management Pearls
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Therapy
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References
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Last Reviewed:11/03/2019
Last Updated:09/17/2020
Last Updated:09/17/2020
Patient Information for Generalized anxiety disorder
Overview
Generalized anxiety disorder refers to a condition of excessive and persistent worrying and distress that seems to be beyond your control that lasts for 6 months or more. Heightened anxiety may impair daily functioning and may cause mental and physical symptoms.Who’s At Risk
Adults, children, and adolescents may show signs of excessive anxiety over a long period of time. Sometimes anxiety is accompanied by other mental health conditions, such as panic disorder, depression, phobias, or obsessive-compulsive disorder.Generalized anxiety disorder may be associated with drug or alcohol abuse. It may also be associated with sexual and physical abuse.
Signs & Symptoms
Generalized anxiety disorder presents as excessive and persistent anxiety, dread, and/or worry with edginess, irritability, restlessness, and an unreasonable fear that something bad is about to happen. Physical symptoms include nausea, vomiting, headache, muscle tension, sweating, shaking, and stomach pain.Self-Care Guidelines
The patient with generalized anxiety disorder will need to fully participate in a treatment plan with techniques for dealing with daily challenges. It may help to reduce intake of caffeine and increase physical exercise.When to Seek Medical Care
When you suspect that worry, fear, and anxiety have become paralyzing and are affecting your daily functioning, contact your health care provider to begin assessment and treatment.Treatments
Your health care provider may recommend behavioral therapy, medication, or both.Cognitive behavioral therapy is short-term, goal-oriented counseling with training to learn new ways to respond to anxiety triggers.
If medication is prescribed, the type used will depend on other medical or emotional conditions being managed, weighing the benefits against possible side effects such as drowsiness or sleep disturbances.
Over a period of time, treatments may be adjusted to find which therapies work best for you.