Diagnosis of Generalized Anxiety Disorder (GAD)

Diagnosis of generalized anxiety disorder can be difficult, since the distinction between normal anxiety and generalized anxiety disorder (GAD) is not always apparent. Diagnosis is based on a physical exam, psychological evaluation, and the criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The symptoms of generalized anxiety disorder must be present for at least six months and cause impairment in your ability to function.

Initial Assessment

After obtaining your medical history, you may be asked about worries, anxiety, “nerves,” stress, and other symptoms. Your healthcare provider may ask whether your anxiety is acute (brief or intermittent) or chronic (persistent).

Acute anxiety lasts from hours to weeks and usually occurs in response to a particular stressor. Persistent anxiety lasts from months to years and may be considered a part of your temperament. Although persistent anxiety does not normally occur in response to stress, in susceptible people stress may increase levels of persistent anxiety.

Evaluation of Medical Disorders

Before generalized anxiety disorder can be diagnosed, your healthcare provider will look for and rule out other medical disorders that could cause your symptoms. Medical conditions commonly associated with anxiety include: hypoglycemia , irritable bowel syndrome , chronic pain conditions, hyperthyroidism , Cushing’s disease , mitral valve prolapse , carcinoid syndrome, hypocalcemia, chronic obstructive pulmonary disease , heart failure, and pheochromocytoma .

Your healthcare provider should also ask what medications, herbal supplements, and vitamins you take. You may be asked to stop taking certain medications or supplements so that your healthcare provider can more accurately pinpoint the cause of your symptoms. Medications that can contribute to or worsen anxiety include:

  • Steroids
  • Over-the-counter cold remedies and diet pills
  • Antidepressants
  • Digoxin
  • Thyroxine
  • Theophylline

Evaluation for Substance Abuse

Use or withdrawal from addictive substances can cause anxiety. Your healthcare provider may ask about your use of alcohol, caffeine, nicotine, addictive medications (particularly sedatives), illegal drugs, and other substances.

Evaluation of Other Psychiatric Disorders

You may be tested for depression , panic disorder , post tranumatic stress disorder , social phobia , obsessive-compulsive disorder , and other psychiatric disorders that often occur with generalized anxiety disorder.

References:

American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html.

Moore DP, Jefferson JW. Handbook of Medical Psychiatry . 2nd ed. Philadelphia: Elsevier Mosby; 2004.

Ballenger JC, Davidson JR, Lecrubier Y, et al. Consensus statement on generalized anxiety disorder from the International consensus Group on Depression and Anxiety. J Clin Psychiatry. 2001;62(11):53-58

Flint AJ. Generalised anxiety disorder in elerly patients: epidemiology, diagnosis and treatment options. Drugs Aging. 2005;22:101-14



Last reviewed February 2007 by David Juan, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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