Generalised Anxiety Disorder Flashcards
Who is GAD more common in?
Females (2:1 ratio females:males)
what is the lifetime prevalence of GAD?
5%
What are risk factors of GAD?
- Being aged 35-54
- Being divorced or separated
- Living alone or as a lone parent
What are protective factors of GAD?
- Being aged 16-24
* Being married or cohabiting
What is the aetiology of GAD?
- Genetic predisposition
- Stress – work, financial, relationship
- Event –losing/gaining spouse/job, moving house, bereavement
What are the cognitive Sx?
- Agitation/irritability
- Feelings of impending doom
- Poor concentration
- Difficulty getting to sleep (insomnia)
- Excessive concern about self and bodily functions
- Repetitive thoughts and activities
- Fatigue
What are somatic Sx of GAD?
- Muscle tension
- Trembling
- Sense of collapse
- Goose bumps
- ‘Butterflies’ in stomach
- Hyperventilation – tinnitus, tetany, tingling, chest pains
- Headache
- Sweating
- Palpitations
- Nausea
- ‘Lump in throat’ unrelated to swallowing – GLOBUS HYSTERICUS
What behavioural Sx may be experienced with GAD?
- Avoidance
- Dependence on person or object
- Reassurance seeking
What autonomic arousal Sx are experienced with GAD?
Palpitations, accelerated HR, sweating, trembling/shaking, dry mouth
Which chest/abdomen Sx may be experienced?
- Difficulty breathing
- Feeling of choking
- Chest pain/discomfort
- Palpitations
- Nausea/abdominal distress (churning/butterflies in stomach)
Symptoms involving mental state that may be experienced with GAD?
- Feeling dizzy, unsteady, faint or light headed
- Feeling that objects are unreal (derealisation) or that the self is ‘not really here’ (depersonalisation)
- Feeling of losing control, passing out, going crazy
- Fear of dying/impending doom
What general symptoms may be experienced?
- Hot flushes or cold chills
- Numbness or tingling sensations
- Muscle tension or aches and pains
- Restlessness and inability to relax
- Feeling on edge, mentally tense
- Lump in throat or difficulty swallowing
what other non-specific symptoms are potentially experienced?
- Exaggerated response to minor surprises or being startled
- Difficulty concentrating or mind ‘going blank’ because of worrying or anxiety
- Persistent irritability
- Difficult getting to sleep due to worrying
What are the diagnostic criteria for GAD?
• Excessive anxiety and worry for more days than not for at least 6 months, about a WIDE RANGE of events or activities
• Person finds it difficult to control the worry
• Anxiety and worry are associated with three or more of following symptoms:
o Restlessness/Feeling on edge
o Easily fatigued
o Difficulty concentrating/mind going blank
o Irritability
o Muscle tension
o Sleep disturbance
What is the DDx of GAD?
• Panic disorder +/- agoraphobia
• PTSD
• OCD
• Phobias e.g. arachnophobia
• Social phobia (Social Anxiety Disorder)
• Acute stress disorder
• OTHERS:
o Schizophrenia – could be due to unexpressed delusional ideas
o Dementia – often associated with anxiety and depression
o Depression and anxiety – freq. co-exist
o Alcoholism – anxiety is a side effect of withdrawal
o Thyrotoxicosis – may produce irritability, restlessness, tremor and tachycardia
o Phaeochromocytoma – multiple endocrine neoplasia (MEN2)
o Hypoglycaemia
