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Generalized anxiety disorder

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Generalized anxiety disorder
Generalized anxiety disorder
Classification and external resources ICD-10 ICD-9 MedlinePlus F41.1 [1] [2] [3]

300.02 000917

Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actualsource of worry. In the case of this disorder, symptoms must last at least 6 months.[4] This excessive worry often interferes with daily functioning, as individuals suffering GAD typically anticipate disaster, and are overly concerned about everyday matters such as health issues, money, death, family problems, friend problems, relationship problems or work difficulties.[5] Individuals often exhibit avariety of physical symptoms, including fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, bouts of difficulty breathing, difficulty concentrating, trembling, twitching, irritability, agitation, sweating, restlessness, insomnia, hot flashes, and rashes and inability to fully control the anxiety (ICD-10).[6] These symptoms must beconsistent and on-going, persisting at least six months, for a formal diagnosis of GAD to be introduced.[5] Approximately 6.8 million American adults experience GAD,[7] and 2 percent of adult Europeans, in any given year, experience GAD.[8] Standardized rating scales such as GAD-7 can be used to assess severity of generalized anxiety disorder symptoms.[9] It is the most common cause of disabilityin the workplace in the United States.[10]

Prevalence
The World Health Organization's Global Burden of Disease project did not include generalized anxiety disorders.[11] In lieu of global statistics, here are some prevalence rates from around the world: • • • • • Australia: 3 percent of adults[11] Canada: Between 3 and 5 percent of adults Italy: 2.9 percent[12] Taiwan: 0.4 percent[12] UnitedStates: approx. 3.1 percent of people age 18 and over in a given year (9.5 million) [7]

Epidemiology
The usual age of onset is variable - from childhood to late adulthood, with the median age of onset being approximately 31 (Kessler, Berguland, et al., 2005). Most studies find that GAD is associated with an earlier and more gradual onset than the other anxiety disorders. Women are two to threetimes more likely to suffer from generalized anxiety disorder than men, although this finding appears to be restricted to only developed countries; the spread of GAD is somewhat equal in developing nations. GAD is also common in the elderly population.[13]

Generalized anxiety disorder

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Potential causes
Some research suggests that GAD may run in families,[14] and it may also grow worseduring stress. GAD usually begins at an earlier age and symptoms may manifest themselves more slowly than in most other anxiety disorders.[15] Some people with GAD report onset in early adulthood, usually in response to a life stressor. Once GAD develops, it can be chronic, but can be managed, if not all-but-alleviated, with proper treatment.[16]

Substance induced
Long-term use ofbenzodiazepines can worsen underlying anxiety,[17][18] with evidence that reduction of benzodiazepines can lead to a lessening of anxiety symptoms.[19] Similarly, long-term alcohol use is associated with anxiety disorders,[20] with evidence that prolonged abstinence can result in a disappearance of anxiety symptoms.[21] However, it can take up to 2 years for anxiety symptoms to return to baseline in about aquarter of people recovering from alcoholism.[22] In one study in 1988–90, illness in approximately half of patients attending mental health services at British hospital psychiatric clinic, for conditions including anxiety disorders such as panic disorder or social phobia, was determined to be the result of alcohol or benzodiazepine dependence. In these patients, anxiety symptoms, while...