Generalized anxiety disorder: clinical presentation, diagnostic features, and guidelines for clinical practice

Abstract

Generalized anxiety disorder (GAD) is a prevalent and disabling disorder characterised by persistent worrying, anxiety symptoms, and tension. General practitioners and mental healthcare professionals frequently misdiagnose the presenting symptoms. This article addresses the clinical presentation of GAD and provides guidelines for discriminating GAD from other disorders, based on theoretical considerations and clinical experience. Debate relating to the validity of the definition of GAD is discussed, and suggestions are made for improving the criteria for GAD, which may guide future versions of classification systems such as the Diagnostic and Statistical Manual.

Differences in latency to first pharmacological treatment (duration of untreated illness) in anxiety disorders: a study on patients with panic disorder, generalized anxiety disorder and obsessive–compulsive disorder

“…benzodiazepines). 37,38 GAD may be erroneously considered a mild condition that leads to minimal distress. 39 From this perspective, previous studies have suggested that GAD is associated with relatively little impairment 40 and that individuals with GAD do not urgently require treatment.…”

“…Moreover, patients affected by GAD frequently have a first access to general practitioners, receiving symptomatic medications (i.e. benzodiazepines) . GAD may be erroneously considered a mild condition that leads to minimal distress .…”

Risk Factors, Clinical Presentations, and Functional Impairments for Generalized Anxiety Disorder in Military Personnel and the General Population in Canada

“…[2][3][4][5][6][7] GAD is highly comorbid with other mental disorders in the general population. 2,[4][5][6][8][9][10][11][12][13] The severity of GAD symptoms and comorbidity with other mental disorders is associated with an increased level of impairment. 5,7,14 However, substantial research suggests that GAD is associated with significant functional impairment independent of comorbid conditions.…”

“…3,5,9,12,13,15,16 GAD is also associated with poorer self-reported health, 16 psychological well-being, 17 impaired physical functioning, 17 lower quality of life, 9,17 and suicidal ideation and attempts. 9,18,19 Individuals with GAD are high users of primary care services; 4,6,9,14,15 yet most do not seek treatment for worry but, rather, for more vague, general, and nonspecific problems, such as headaches, gastrointestinal distress, sleep problems, muscle tension, and irritability. 4,6,20 As a result, GAD is poorly recognized in primary care settings, often not diagnosed, and results in many individuals with GAD receiving inadequate or ineffective treatment.…”

Psychometric properties of the Generalized Anxiety Disorder Questionnaire - IV (GAD-Q-IV) in postpartum mothers.

“…If GAD is identified and treated during the postpartum period, some of the chronic ( Prenoveau et al, 2013 ) and deleterious effects of GAD ( Boschen, 2011 ) and negative childhood outcomes ( Glasheen, Richardson, & Fabio, 2010 ) might be prevented. When health-care professionals appropriately diagnose GAD, adequate treatments can be recommended ( Van der Heiden, Methorst, Muris, & Van der Molen, 2011 ).…”