Anxiety (Generalized Anxiety Disorder)
Anxiety (Generalized Anxiety Disorder) is a topic covered in the 5-Minute Clinical Consult.
5-Minute Clinical Consult Explore these free sample topics:
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- Persistent, excessive, and difficult-to-control worry associated with significant symptoms of motor tension, autonomic hyperactivity, and/or disturbances of sleep or concentration.
- System(s) affected: nervous (resulting in increased sympathetic tone and increased catecholamine release); may have secondary effects on other symptoms such as cardiac (tachycardia) and GI (nausea, irregular bowels)
- 12-month prevalence rate: 2–3%
- Lifetime prevalence rate: 5%
- Onset can occur any time in life but is typically during adulthood; median age of onset in the United States is 31 years.
- Predominant sex: female > male (2:1) (1)
Etiology and Pathophysiology
- May be mediated by abnormalities of neurotransmitter systems (i.e., serotonin, norepinephrine, and γ-aminobutyric acid [GABA])
- Associated with altered regional brain function (increased activity in the amygdala and prefrontal cortex) (2)
- Strongly linked to depression in heritability studies
- A variant of the serotonin transporter gene (5HT1A) may contribute to both conditions; other genes (such as that for glutamic acid decarboxylase) also may play a role.
- Caucasian race
- Adverse life events: stress, medical illness, disability, unemployment, and childhood physical and mental abuse
- Family history
- Lack of social support
- Comorbid psychiatric disorders (3)
- Regular exercise is associated with decreased anxiety and depression.
- CBT and parental intervention in children with social withdrawal or early anxiety may protect against the development of GAD (3).
Commonly Associated Conditions
- Major depressive disorder (>60%), dysthymia, bipolar disorder
- Alcohol/drug abuse
- Cigarette smoking in adolescence
- Panic disorder, agoraphobia, simple phobia, social anxiety disorder, anorexia nervosa