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The International Journal of... Dec 2002Generalized anxiety disorder (GAD) is a severe and chronic anxiety disorder characterized by uncontrollable worrying and somatic anxiety (tension, insomnia and... (Review)
Review
Generalized anxiety disorder (GAD) is a severe and chronic anxiety disorder characterized by uncontrollable worrying and somatic anxiety (tension, insomnia and hypervigilance). It is a common condition, with lifetime prevalence rates for DSM-IV GAD in the general population of approx. 5-6% being reported. In addition, like other anxiety disorders, GAD also shows comorbidity with depression and most of the other anxiety disorders. This article reviews data on the prevalence of GAD, its comorbidity with depression, and its social and economic impact. Proposed neurobiological mechanisms for GAD are discussed, since an understanding of these may help in the development of future therapies. Finally, current pharmacological and non-pharmacological treatment options for GAD are reviewed, with particular attention being paid to published clinical-trial data.
Topics: Anti-Anxiety Agents; Antidepressive Agents; Anxiety Disorders; Depressive Disorder; Diagnosis, Differential; Disease Progression; Humans; Psychotherapy
PubMed: 12466031
DOI: 10.1017/S1461145702003048 -
The Journal of Nervous and Mental... Aug 2012This article reviews the main issues associated with the concept and the diagnosis of generalized anxiety disorder (GAD) and examines the proposed DSM-5 diagnostic... (Review)
Review
This article reviews the main issues associated with the concept and the diagnosis of generalized anxiety disorder (GAD) and examines the proposed DSM-5 diagnostic criteria for GAD. The lack of specific features, which is the primary issue for GAD, will not be addressed in DSM-5. The hallmark of the condition will remain pathological worry, although it also characterizes other disorders. Likewise, the proposed behavioral diagnostic criteria lack specificity for GAD, and it is not clear how these will be assessed. The proposed changes will lower the diagnostic threshold for GAD in DSM-5. Although this will not necessarily lead to a better recognition of GAD and an improvement in the perception of its relevance and clinical utility, many currently subthreshold cases will qualify for this diagnosis. The likely inclusion of many such "false-positives" will result in an artificial increase in the prevalence of GAD and will have further negative consequences.
Topics: Anxiety; Anxiety Disorders; Diagnostic and Statistical Manual of Mental Disorders; Humans; Prevalence
PubMed: 22850300
DOI: 10.1097/NMD.0b013e318263f947 -
Psychiatry and Clinical Neurosciences Dec 2015In the 3 decades since Liebowitz's review of 'a neglected anxiety disorder,' controversy and challenges have remained in the study of social anxiety disorder (SAD). This... (Review)
Review
In the 3 decades since Liebowitz's review of 'a neglected anxiety disorder,' controversy and challenges have remained in the study of social anxiety disorder (SAD). This review examines evidence around the classification and subtyping of SAD, focusing on generalized SAD. Substantial discrepancies and variation in definition, epidemiology, assessment, and treatment of generalized SAD exist as the international literature on it has grown. In East Asian cultures in particular, study of taijin kyofusho has been important to a broadened conceptualization of SAD into generalized SAD. Despite important progress with biological and other studies, many challenges in the understanding of generalized SAD will remain in the years to come.
Topics: Agoraphobia; Anxiety Disorders; Australia; Autism Spectrum Disorder; Canada; Comorbidity; Depressive Disorder; Europe; Asia, Eastern; Humans; Middle East; Nigeria; Panic Disorder; Personality Disorders; Phobic Disorders; Schizophrenia; South Africa; Substance-Related Disorders; United States
PubMed: 26121185
DOI: 10.1111/pcn.12327 -
The Journal of Clinical Psychiatry 2009Generalized anxiety disorder (GAD) is a common illness with diagnostic criteria that have changed substantially over time. Symptoms of GAD overlap with those of major... (Review)
Review
Generalized anxiety disorder (GAD) is a common illness with diagnostic criteria that have changed substantially over time. Symptoms of GAD overlap with those of major depressive disorder to such an extent that studying one disorder without studying the other may be impossible. Such an overlap, combined with potentially inappropriate diagnostic criteria for GAD, makes diagnosing and researching GAD challenging. Recent research into the genetics and neural circuitry of GAD may suggest solutions for the disorder's diagnostic controversies and point the way to productive future studies of etiology and pathophysiology.
Topics: Anxiety Disorders; Aspartic Acid; Brain; Cognition; Comorbidity; Creatine; Depressive Disorder, Major; Diagnosis, Differential; Genetic Linkage; Humans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Neurobiology; Risk Factors; Twin Studies as Topic
PubMed: 19371502
DOI: 10.4088/jcp.s.7002.03 -
Child and Adolescent Psychiatric... Jul 2023This review summarizes the developmental epidemiology of childhood and adolescent anxiety disorders. It discusses the coronavirus disease of 2019 (COVID-19) pandemic,... (Review)
Review
This review summarizes the developmental epidemiology of childhood and adolescent anxiety disorders. It discusses the coronavirus disease of 2019 (COVID-19) pandemic, sex differences, longitudinal course, and stability of anxiety disorders in addition to recurrence and remission. The trajectory of anxiety disorders-whether homotypic (ie, the same anxiety disorder persists over time) or heterotypic (ie, an anxiety disorder shifts to a different diagnosis over time) is discussed with regard to social, generalized, and separation anxiety disorders as well as specific phobia, and panic disorder. Finally, strategies for early recognition, prevention, and treatment of disorders are discussed.
Topics: Adolescent; Humans; Female; Male; Child; COVID-19; Anxiety Disorders; Phobic Disorders; Panic Disorder; Anxiety, Separation
PubMed: 37201964
DOI: 10.1016/j.chc.2023.02.001 -
Current Topics in Behavioral... 2018In the present chapter, we review the literature focusing on oxytocin (OT)-centered research in anxiety spectrum conditions, comprising separation anxiety disorder,... (Review)
Review
In the present chapter, we review the literature focusing on oxytocin (OT)-centered research in anxiety spectrum conditions, comprising separation anxiety disorder, specific phobias, social anxiety disorder (SAD), panic disorder, generalized anxiety disorder, and anxiety-related endophenotypes (e.g., trust behavior, behavioral inhibition, neuroticism, and state/trait anxiety). OT receptor gene (OXTR) polymorphisms have been implicated in gene-environment interactions with attachment style and childhood maltreatment and to influence clinical outcomes, including SAD intensity and limbic responsiveness. Epigenetic OXTR DNA methylation patterns have emerged as a link between categorical, dimensional, neuroendocrinological, and neuroimaging SAD correlates, highlighting them as potential peripheral surrogates of the central oxytocinergic tone. A pathophysiological framework of OT integrating the dynamic nature of epigenetic biomarkers and the summarized genetic and peripheral evidence is proposed. Finally, we emphasize opportunities and challenges of OT as a key network node of social interaction and fear learning in social contexts. In conjunction with multi-level investigations incorporating a dimensional understanding of social affiliation and avoidance in anxiety spectrum disorders, these concepts will help to promote research for diagnostic, state, and treatment response biomarkers of the OT system, advancing towards indicated preventive interventions and personalized treatment approaches.
Topics: Anxiety Disorders; DNA Methylation; Fear; Gene-Environment Interaction; Humans; Interpersonal Relations; Oxytocin; Receptors, Oxytocin; Social Environment
PubMed: 28812274
DOI: 10.1007/7854_2017_25 -
Harvard Review of Psychiatry 1997Practicing psychiatrists frequently encounter elderly patients with generalized anxiety disorder or panic disorder. Unfortunately, the empirical literature regarding the... (Review)
Review
Practicing psychiatrists frequently encounter elderly patients with generalized anxiety disorder or panic disorder. Unfortunately, the empirical literature regarding the assessment, diagnosis, and treatment of these illnesses in older individuals is sparse, despite the attention directed to them in younger patients. In this paper studies of generalized anxiety and panic disorders among the elderly are reviewed and compared to similar investigations among younger adults to assess our current understanding of the epidemiology, etiology, diagnosis, and treatment of these conditions. Articles were selected from those retrieved by Index Medicus (papers in English, published in 1992 or later; search terms "anxiety," "anxiety disorders," "panic disorder," and "elderly").
Topics: Aged; Anxiety Disorders; Diagnosis, Differential; Humans; Middle Aged; Panic Disorder
PubMed: 9385016
DOI: 10.3109/10673229709034721 -
Journal of Anxiety Disorders 1999The relationship between selective mutism (SM) and childhood anxiety disorders is illustrated through an examination of their temperamental, environmental, and... (Review)
Review
The relationship between selective mutism (SM) and childhood anxiety disorders is illustrated through an examination of their temperamental, environmental, and biological etiologies. SM is also explored as a symptom of the specific anxiety disorders of social phobia, separation anxiety, and posttraumatic stress disorder. The etiology and symptom overlap demonstrates SM as being an anxiety disorder or a variant of a specific anxiety disorder. The conceptualization of SM as an anxiety disorder is helpful in effectively treating afflicted children. There is enough evidence in the current literature to challenge the current classification, from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders of SM as an Other Disorder of Infancy, Childhood, and Adolescence.
Topics: Anxiety Disorders; Anxiety, Separation; Child; Child Development; Female; Humans; Male; Mutism; Phobic Disorders; Sex Factors; Shyness; Stress Disorders, Post-Traumatic
PubMed: 10504110
DOI: 10.1016/s0887-6185(99)00012-2 -
Annual Review of Clinical Psychology 2005This chapter provides a review of recent empirical developments, current controversies, and areas in need of further research in relation to factors that are common as... (Review)
Review
This chapter provides a review of recent empirical developments, current controversies, and areas in need of further research in relation to factors that are common as well as specific to the etiology and maintenance of panic disorder, phobias, and generalized anxiety disorder. The relative contribution of broad risk factors to these disorders is discussed, including temperament, genetics, biological influences, cognition, and familial variables. In addition, the role that specific learning experiences play in relation to each disorder is reviewed. In an overarching hierarchical model, it is proposed that generalized anxiety disorder, and to some extent panic disorder, loads most heavily on broad underlying factors, whereas specific life history contributes most strongly to circumscribed phobias.
Topics: Anxiety Disorders; Arousal; Association Learning; Cognition; Humans; Panic Disorder; Parent-Child Relations; Phobic Disorders; Risk Factors; Temperament
PubMed: 17716087
DOI: 10.1146/annurev.clinpsy.1.102803.143857 -
Depression and Anxiety 2000Social anxiety disorder (social phobia) is a disabling psychiatric condition, characterized by a fear of negative evaluation by others. Epidemiological studies have... (Review)
Review
Social anxiety disorder (social phobia) is a disabling psychiatric condition, characterized by a fear of negative evaluation by others. Epidemiological studies have shown a high prevalence of the condition in the general population; the disorder is more common in women than in men. Social anxiety disorder has a typical onset during adolescence and a chronic course; remission rarely occurs without therapeutic intervention. Comorbid psychiatric conditions such as depression and alcoholism commonly occur in patients with preexisting social anxiety disorder, and increase the burden of the condition. Two subtypes of social anxiety disorder have been identified: "nongeneralized" and "generalized"; the latter form causes greater disability and is more often associated with comorbidity. The socioeconomic impact of social anxiety disorder on both sufferers and the community is considerable. For a person with social anxiety disorder, quality of life is greatly reduced; work, social, and personal relationships are all affected. Social anxiety disorder demands increased recognition, so that sufferers receive the treatment they need, in order to improve their quality of life through better social functioning.
Topics: Adolescent; Adult; Anxiety Disorders; Comorbidity; Cross-Sectional Studies; Female; Humans; Male; Phobic Disorders
PubMed: 10875048
DOI: 10.1002/(sici)1520-6394(2000)11:3<87::aid-da1>3.3.co;2-0