General anxiety disorder

Generalized and persistent excessive anxiety associated with psychological and somatic complaints.

Associated with an unpleasant mood characterized by worry, and is an adaptive response to perceived threats that can develop into a maladaptive anxiety disorder if it becomes severe and chronic.

GAD is a common disorder of which the central feature is excessive worry about a number of different events.

GAD is characterized by presence of anxiety and worry related to several events/activities that is difficult to control along with 3 or more of the following 6 symptoms: restlessness or feeling keyed up or on edge; being easily fatigued; difficulty concentrating or mind going blank; irritability; muscle tension; and sleep disturbances.

GAD is a common disorder with excessive worry about a number of different events, excessive anxiety and difficulty controlling worrisome thoughts that persists for at least 6 months.

Antidepressants provide a modest-to-moderate reduction in anxiety in GAD.

Anxiety disorders of the most common mental illnesses in the US.

Effects 40 million adults aged 18 or older.

Affects 18 % of the population.


Generalized anxiety disorder (GAD) is estimated to affect 7.8% of adults in the United States during their lifetime.

Only one third of affected people receive treatment.

Patients for 3-5 times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than those without anxiety disorders.

Key symptoms include excessive anxiety about multiple events and issues, and difficulty controlling worrisome thoughts that persists for at least 6 months.

At least the presence of one symptom of autonomic arousal such as palpitation, sweating, trembling or dry mouth necessary for diagnosis.

Common in late life with a prevalence up to 7.3% in the community and 11.2% in primary care (Tolin).

Includes symptoms of restlessness with easy fatigue, difficulty in concentration, sleep disturbance and muscle tension.

Worry over minor matters.

Exclusion of other disorders associated with anxiety is necessary and that includes panic disorder, hypochondriasis, obsessive-compulsive disorder, eating disorders and substance misuse disorders.

Duration of symptoms 6 months or longer.

Prevalence in women almost double that of men.

Common in individuals with chronic illness.

Late life problems predict for increased physical disabilities, memory problems, decreased quality of life, and increased mortality.

It is recommended screening women and adolescent girls aged 13 years or older, including pregnant and postpartum women, for anxiety.

May be a risk factor for the development of depression and is commonly associated with depressive disorders.

More than 50% of patients with depression report clinically significant anxiety and have greater refractoriness to standard treatments than patients who have depression without anxiety.


With anxiety disorders there may be difficulty accessing calming feedback from the frontal cortex.



For the initial management of GAD, evidence-based psychotherapies such as cognitive behavioral therapy are considered as first-line treatments.


Usually treated with benzodiazepines and antidepressants.

Can have negative impact on treatment outcomes since individuals with this problem are less likely to adhere to medical treatments.

Exercise training is useful, especially in those preferred nonpharmacologic treatments, as he can reduce symptoms among sedentary patients who have a chronic illness (Herring MP).

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