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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)
- 12-month prevalence rate: 3.1%
- Lifetime prevalence rate: 5.7%
- Onset can occur any time in life, from adolescence to adulthood; median age of onset in the US is 31 years.
- Predominant sex: Female > Male (2:1)
- Anxiety accounts for 5–8% of primary care office visits.
Etiology and Pathophysiology
fMRI studies display decreased amygdala connectivity bilaterally.
Mediated by abnormalities of neurotransmitter systems (i.e., serotonin, norepinephrine, and γ-aminobutyric acid [GABA])Genetics
- 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, childhood physical and mental abuse
- Family history
- Lack of social support
- Lesbian/Bisexual women at increased risk
Regular exercise is associated with decreased anxiety and depression.
Commonly Associated Conditions
- Major depressive disorder (>60%), dysthymia, bipolar disorder
- Alcohol/Drug abuse (37.6%/27.6%)
- Cigarette smoking in adolescence
- Panic disorder, agoraphobia, simple phobia, social anxiety disorder, anorexia nervosa