5-Minute Clinical Consult
Anxiety (Generalized Anxiety Disorder)
Anxiety (Generalized Anxiety Disorder) is a topic covered in the 5-Minute Clinical Consult.
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Basics
Description
- 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 (increased sympathetic tone and catecholamine release), cardiac (tachycardia), pulmonary (dyspnea), and GI (nausea, irregular bowels)
Epidemiology
Prevalence
- Lifetime prevalence in United States 5.1–11.9%
- Onset at any age but typically during adulthood; median age of onset in the United States is 31 years.
- Female > male (2:1)
- Generally recurrent and chronic in nature; fluctuates in severity
- COVID-19 survivors have increased incidence of anxiety, depression, and posttraumatic stress disorder (PTSD) (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)
Genetics
A serotonin transporter gene (5HT1A) may contribute to GAD.
Risk Factors
- Adverse life events (illness, poverty, etc.)
- Family history
- Comorbid psychiatric disorders (2)
General Prevention
- Physical activity and cardiorespiratory fitness are associated with decreased generalized anxiety and depression.
- Cognitive-behavioral therapy (CBT) and parental intervention in children with early anxiety may protect against GAD (2).
Commonly Associated Conditions
- Major depressive disorder (>60%), dysthymia, bipolar disorder, schizophrenia
- Alcohol/drug abuse; cigarette smoking in adolescence
- Panic disorder, agoraphobia, phobia, social anxiety disorder, anorexia nervosa, PTSD, obsessive-compulsive disorder (OCD), ADHD
- Somatoform and pain disorders
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- 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 (increased sympathetic tone and catecholamine release), cardiac (tachycardia), pulmonary (dyspnea), and GI (nausea, irregular bowels)
Epidemiology
Prevalence
- Lifetime prevalence in United States 5.1–11.9%
- Onset at any age but typically during adulthood; median age of onset in the United States is 31 years.
- Female > male (2:1)
- Generally recurrent and chronic in nature; fluctuates in severity
- COVID-19 survivors have increased incidence of anxiety, depression, and posttraumatic stress disorder (PTSD) (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)
Genetics
A serotonin transporter gene (5HT1A) may contribute to GAD.
Risk Factors
- Adverse life events (illness, poverty, etc.)
- Family history
- Comorbid psychiatric disorders (2)
General Prevention
- Physical activity and cardiorespiratory fitness are associated with decreased generalized anxiety and depression.
- Cognitive-behavioral therapy (CBT) and parental intervention in children with early anxiety may protect against GAD (2).
Commonly Associated Conditions
- Major depressive disorder (>60%), dysthymia, bipolar disorder, schizophrenia
- Alcohol/drug abuse; cigarette smoking in adolescence
- Panic disorder, agoraphobia, phobia, social anxiety disorder, anorexia nervosa, PTSD, obsessive-compulsive disorder (OCD), ADHD
- Somatoform and pain disorders
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Citation
Domino, Frank J., et al., editors. "Anxiety (Generalized Anxiety Disorder)." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688258/all/Anxiety__Generalized_Anxiety_Disorder_.
Anxiety (Generalized Anxiety Disorder). In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688258/all/Anxiety__Generalized_Anxiety_Disorder_. Accessed April 2, 2023.
Anxiety (Generalized Anxiety Disorder). (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688258/all/Anxiety__Generalized_Anxiety_Disorder_
Anxiety (Generalized Anxiety Disorder) [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 April 02]. Available from: https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688258/all/Anxiety__Generalized_Anxiety_Disorder_.
* Article titles in AMA citation format should be in sentence-case
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T1 - Anxiety (Generalized Anxiety Disorder)
ID - 1688258
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688258/all/Anxiety__Generalized_Anxiety_Disorder_
PB - Wolters Kluwer
ET - 27
DB - 5-Minute Clinical Consult
DP - Unbound Medicine
ER -
