Anxiety (Generalized Anxiety Disorder)
- Persistent, excessive, and difficult-to-control worry associated with significant symptoms of motor tension, autonomic hyperactivity, and/or disturbances of sleep or concentration
- System(s) affected: nervous (increased sympathetic tone and catecholamine release), cardiac (tachycardia), pulmonary (dyspnea), and GI (nausea, irregular bowels)
- Lifetime prevalence in United States: 5.1–11.9%
- Onset at any age but typically during adulthood; median age of onset in the United States is 31 years.
- Female > male (2:1)
Etiology and Pathophysiology
- May be mediated by abnormalities of neurotransmitter systems (i.e., serotonin, norepinephrine, and γ-aminobutyric acid [GABA])
- Associated with altered regional brain function (increased activity in the amygdala and prefrontal cortex)
A serotonin transporter gene (5HT1A) may contribute to GAD.
- Adverse life events (illness, poverty, etc.)
- Family history
- Comorbid psychiatric disorders (1)
- Physical activity and cardiorespiratory fitness are associated with decreased generalized anxiety.
- Cognitive-behavioral therapy (CBT) and parental intervention in children with early anxiety may protect against GAD (1).
Commonly Associated Conditions
- Major depressive disorder (>60%), dysthymia, bipolar disorder, schizophrenia
- Alcohol/drug abuse; cigarette smoking
- Panic disorder, agoraphobia, phobias, social anxiety disorder, anorexia nervosa, PTSD, ADHD
- Somatoform and pain disorders
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