Lecture Notes Generalized anxiety disorder (GAD): Epidemiology, Clinical Manifestations & Diagnosis

Generalized anxiety disorder (GAD) is characterized by excessive worry and anxiety that are difficult to control, cause significant distress and impairment, and last for at least six months.

Twelve-month and lifetime prevalence rates of GAD, based on DSM-IV criteria, are estimated at 2.1 and 4.1 percent, respectively. Approximately twice as many women as men have the disorder.

Major depression is a common comorbidity of GAD, affecting as many as one in three patients with the disorder. Substance use disorders and other anxiety disorders also occur concurrently with GAD.

GAD is characterized by a maladaptive response to stressful stimuli primarily involving the neurotransmitters norepinephrine, serotonin, and gamma-aminobutyric acid (GABA). Genetic factors appear to play a modest role in the etiology of GAD, while early environment is thought to be influential.

DSM-IV-TR diagnostic criteria for GAD include excessive anxiety and worry about a number of events or activities, occurring more days than not for at least six months, that are out of proportion to the likelihood or impact of feared events. Somatic symptoms of GAD can include fatigue, muscle tension, memory loss, and insomnia.

Diagnostic criteria for generalized anxiety disorder  Excessive anxiety and worry about a number of events or activities, occurring more days than not for at least six months, that are out of proportion to the likelihood or impact of feared events. The worry is pervasive and difficult to control. 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 six months): Restlessness or feeling keyed up or on edge Being easily fatigued Difficulty concentrating or mind going blank Irritability Muscle tension Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep) The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.