Generalised anxiety disorder

Question 1

Define generalised anxiety disorder.

Answer 1

Generalised severe freefloating anxiety (not linked to specific event or circumstance)

Question 2

What are risk factors for generalised anxiety disorder?

Answer 2

Genetic predisposition

General life stress

Current stress

Question 3

Summarise the epidemiology of generalised anxiety disorder.

Answer 3

High risk in childhood eposure to separation, demands for high achievement and excessive conformity. Lifetime prevalence 5%.

Question 4

What are the signs and symptoms of generalised anxiety disorder?

Answer 4

Sx present for several days, several weks at a time. These include:

• Apprehension: wories about future, on edge feeling
• Motor tension: restless, fidgeting, headaches
• Autonomic overactivity: high HR, sweating, dry mouth, epigastric pain.

Question 5

What investigations should be performed for generalised anxiety disorder?

Answer 5

FBC

U+Es

TFTs

Ca2+

LFTs

Question 6

What is the management for generalised anxiety disorder?

Answer 6

Psychoeducation, distraction techniques, cognitive control, breathing/reflection techniques.

BZD may be useful in short term but not in long term due to dependence.

CBT

Question 7

What are complications associated with generalised anxiety disorder? What is the prognosis of generalised anxiety disorder?

Answer 7

Depressive illness, substance misuse

Often chronic and worse at times of stress.

Worse prognosis if coexisting psyhciatric illness.