Fast Five Quiz: Generalized Anxiety Disorder

Stephen Soreff, MD

Disclosures

September 20, 2018

Common physical signs of GAD include tremor, tachycardia, tachypnea, sweaty palms, and restlessness. Typically, children and adults with GAD also experience uncomfortable physical symptoms including rapid heartbeat, shortness of breath, increased sweating, stomach cramping, a feeling of a lump in the throat or inability to swallow, frequent need to urinate, dry mouth, nausea, diarrhea, cold and/or clammy hands, headaches, or neck or backaches. A feeling of nervous tension is often accompanied by shaking, trembling, twitching, or body aches. The key here is not to miss a treatable physical illness such as hyperthyroidism or cardiac arrhythmia.

A complete mental status examination should be obtained for each patient with anxiety symptoms, assessing appearance, behavior, ability to cooperate with the exam, level of activity, speech, mood and affect, thought processes and content, insight, and judgment. Patients may exhibit physical signs of anxiety such as sweaty palms, restlessness, and distractibility. Patients are generally oriented x 3 and cooperative. Mood may be normal or depressed. Affect is often preserved but marked by anxiety. Psychotic symptoms are not typical of uncomplicated anxiety disorders. Although not a diagnostic feature, suicidal ideation and completed suicide have been associated with GAD, as prolonged anxiety can prove to be intolerable for some people.

Association of childhood anxiety and irritability strongly correlate across child gender and age. Pediatric anxiety and irritability were similar across children with and without GAD. This suggests that the anxiety-irritability association remains relevant across pediatric anxiety disorders and not uniquely to GAD.

For more on the presentation of GAD, read here.

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