2007

Definition

GAD syndrome of ongoing anxiety about events or thoughts that the patient recognises as excessive and inappropriate

Diagnostic criteria

Xs anxiety/worry occurring more days than not about a number of events and activities for > 6/12

Difficult to control worry Associated with 3 or more of

Restlessness Easily fatigued Poor concentration Irritability Sleep disturbance Muscle tension

Autonomic arousal symptomsPalpitationsSweatingTremblingDry mouth

Symptoms involving chest and abdomen

Breathing difficultyFeeling of chokingChest painNausea or abdominal distress

Symptoms involving mental state Dizziness Unsteady, faint, light

headedness Feeling that objects are unreal

(derealisation) Feeling of loss of control Fear of dying

General symptoms

Hot flushes of cold chills Numbness or tingling

sensations Muscle tension aches and pains Restlessness inability to relax Lump in throat difficulty

swallowing

Exclusions

Panic disorderPhobic anxiety disorderOCDHypochondriacal disorder

Useful treatments

Psychological CBT Anxiety management training Self help books and CD’s

Pharmacological SSRI’s TAD’s Avoid benzodiazepaines