Generalised Anxiety Disorder: Difference between revisions

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== Characteristics/Clinical Presentation  ==
== Characteristics/Clinical Presentation  ==


There are many characteristics/symptoms assosciated with generalized anxiety disorder including:&nbsp;<ref name="Goodman and Fuller">Goodman CC, Fuller KS. Pathology: Implications for the Physical Therapist. 3rd edition. St. Louis, Missouri: Saunders Elsevier, 2009.</ref><ref name="Mayo Clinic">Medical Foundation for Medical Education and Research. Mayo Clinic: Generalized anxiety disorder. http://www.mayoclinic.com/health/generalized-anxiety-disorder/DS00502. Updated September 11, 2009. Accessed February 21, 2010.</ref><ref name="Goodman and Snyder">Goodman CC and Snyder TK. Differential Diagnosis for Physical Therapists: Screening for Referral. 4th edition. St. Louis, Missouri: Saunders Elsevier, 2007.</ref><ref name="NIMH">National Institute of Mental Health. Health and Outreach: Generalized Anxiety Disorder. http://www.nimh.nih.gov/health/publications/anxiety-disorders/generalized-anxiety-disorder-gad.shtml. Updated July 7, 2009. Accessed February 21, 2010.</ref><ref name="Ballas">Ballas, Christos, MD. U.S. National Library of Medicine and National Institutes of Health. Medline Plus: Generalized Anxiety Disorder. Updated January 15, 2009. Accessed February 21, 2010.</ref>  
There are many characteristics/symptoms assosciated with generalized anxiety disorder. The most common include:&nbsp;<ref name="Goodman and Fuller">Goodman CC, Fuller KS. Pathology: Implications for the Physical Therapist. 3rd edition. St. Louis, Missouri: Saunders Elsevier, 2009.</ref><ref name="Mayo Clinic">Medical Foundation for Medical Education and Research. Mayo Clinic: Generalized anxiety disorder. http://www.mayoclinic.com/health/generalized-anxiety-disorder/DS00502. Updated September 11, 2009. Accessed February 21, 2010.</ref><ref name="Goodman and Snyder">Goodman CC and Snyder TK. Differential Diagnosis for Physical Therapists: Screening for Referral. 4th edition. St. Louis, Missouri: Saunders Elsevier, 2007.</ref><ref name="NIMH">National Institute of Mental Health. Health and Outreach: Generalized Anxiety Disorder. http://www.nimh.nih.gov/health/publications/anxiety-disorders/generalized-anxiety-disorder-gad.shtml. Updated July 7, 2009. Accessed February 21, 2010.</ref><ref name="Ballas">Ballas, Christos, MD. U.S. National Library of Medicine and National Institutes of Health. Medline Plus: Generalized Anxiety Disorder. Updated January 15, 2009. Accessed February 21, 2010.</ref>  


*Constant worrying and excessive anxiety (about small or large concerns)<br>  
*Constant worrying and excessive anxiety (about small or large concerns)<br>  
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Anxiety disocrders are often associated with depression and substance abuse. <ref name="Ballas">Ballas, Christos, MD. U.S. National Library of Medicine and National Institutes of Health. Medline Plus: Generalized Anxiety Disorder. Updated January 15, 2009. Accessed February 21, 2010.</ref>  
Anxiety disocrders are often associated with depression and substance abuse. <ref name="Ballas">Ballas, Christos, MD. U.S. National Library of Medicine and National Institutes of Health. Medline Plus: Generalized Anxiety Disorder. Updated January 15, 2009. Accessed February 21, 2010.</ref>  


This is a complete table from the Goodman and Snyder text: Differential Diagnosis for Physical Therapists:<br>
<br>
 
{| cellspacing="1" cellpadding="1" border="1" style="width: 578px; height: 443px;"
|+ This is a complete table from the Goodman and Snyder text: Differential Diagnosis for Physical Therapists:
|-
| colspan="4" | '''Symptoms of Anxiety'''<br>
|-
| '''Physical<br>'''
| '''Behavioral'''<br>
| '''Cognitive'''<br>
| '''Psychologic'''<br>
|-
| Increased sighing respirations<br>
| Hyperalertness<br>
| <br>
| <br>
|-
| Increased blood pressure<br>
| Irritability<br>
| <br>
| <br>
|-
| Tachycardia<br>
| Uncertainty<br>
| <br>
| <br>
|-
| Shortness of breath<br>
| Apprehension<br>
| <br>
| <br>
|-
| Dizziness<br>
| Difficulty with memory or concentration<br>
| <br>
| <br>
|-
| Lump in throat<br>
| Sleep disturbance<br>
| <br>
| <br>
|-
| Muscle tension<br>
| <br>
| <br>
| <br>
|-
| Dry mouth<br>
| <br>
| <br>
| <br>
|-
| Diarrhea<br>
| <br>
| <br>
| <br>
|-
| Nausea<br>
| <br>
| <br>
| <br>
|-
| Clammy hands<br>
| <br>
| <br>
| <br>
|-
| Profuse sweating<br>
| <br>
| <br>
| <br>
|-
| Restlessness, pacing, irritability, difficult concentrating<br>
| <br>
| <br>
| <br>
|-
| Chest pain<br>
| <br>
| <br>
| <br>
|-
| Headache<br>
| <br>
| <br>
| <br>
|-
| Low back pain<br>
| <br>
| <br>
| <br>
|-
| Myalgia (muscle pain, tension, or tenderness)<br>
| <br>
| <br>
| <br>
|-
| Arthralgia (joint pain)<br>
| <br>
| <br>
| <br>
|-
| Abdominal (stomach) distress<br>
| <br>
| <br>
| <br>
|-
| Irritable bowel syndrome (IBS)<br>
| <br>
| <br>
| <br>
|}
 
<br>


== Associated Co-morbidities  ==
== Associated Co-morbidities  ==

Revision as of 22:31, 21 February 2010

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

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Definition/Description[edit | edit source]

According to Goodman and Fuller, anxiety can be defined as a heightened emotional state of concern, worry, or apprehension. It can lead to physiologic arousal causing an increase in heart rate and sweat gland activity.[1]

Anxiety is a normal feeling to encounter; however when one experiences excessive worry, tension, and anxious feelings on a daily basis then he/she may have generalized anxiety disorder (GAD). This disorder is diagnosed with a person demonstrates anxious feelings and constant worry over daily activities for a six-month time frame.[1][2][3]

Prevalence[edit | edit source]

Generalized Anxiety Disorder affects nearly 6.8 million American adults. GAD is a gradually progressing disorder and can occur at any point throughout the lifespan, however is most often occurs between childhood and midlife. Women are two times more likely to develop GAD than men.[4][2]

Characteristics/Clinical Presentation[edit | edit source]

There are many characteristics/symptoms assosciated with generalized anxiety disorder. The most common include: [1][2][3][4][5]

  • Constant worrying and excessive anxiety (about small or large concerns)
  • Difficulty concentrating
  • Excessive sweating
  • Palpitations or rapid heart beat
  • Shortness of breath
  • Stomach/intestinal symptoms
  • Nausea or diarrhea
  • Fatigue
  • Irritability
  • Muslce tension/ muslce aches
  • Headaches
  • Restlessness/ feeling 'on edge'
  • Trembling or easily startled
  • Sleep disturbance: difficulty falling asleep, staying asleep, or restless, unsatisfying sleep

Anxiety disocrders are often associated with depression and substance abuse. [5]


This is a complete table from the Goodman and Snyder text: Differential Diagnosis for Physical Therapists:
Symptoms of Anxiety
Physical
 		Behavioral
 Cognitive
 Psychologic
Increased sighing respirations
 Hyperalertness

Increased blood pressure
 Irritability

Tachycardia
 Uncertainty

Shortness of breath
 Apprehension

Dizziness
 Difficulty with memory or concentration

Lump in throat
 Sleep disturbance

Muscle tension


Dry mouth


Diarrhea


Nausea


Clammy hands


Profuse sweating


Restlessness, pacing, irritability, difficult concentrating


Chest pain


Headache


Low back pain


Myalgia (muscle pain, tension, or tenderness)


Arthralgia (joint pain)


Abdominal (stomach) distress


Irritable bowel syndrome (IBS)



Associated Co-morbidities[edit | edit source]

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Medications[edit | edit source]

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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]

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Causes[edit | edit source]

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Systemic Involvement[edit | edit source]

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Medical Management (current best evidence)[edit | edit source]

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Physical Therapy Management (current best evidence)[edit | edit source]

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Alternative/Holistic Management (current best evidence)[edit | edit source]

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Differential Diagnosis[edit | edit source]

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Case Reports[edit | edit source]

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Resources
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Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. ↑ 1.0 1.1 1.2 Goodman CC, Fuller KS. Pathology: Implications for the Physical Therapist. 3rd edition. St. Louis, Missouri: Saunders Elsevier, 2009.
  2. ↑ 2.0 2.1 2.2 Medical Foundation for Medical Education and Research. Mayo Clinic: Generalized anxiety disorder. http://www.mayoclinic.com/health/generalized-anxiety-disorder/DS00502. Updated September 11, 2009. Accessed February 21, 2010.
  3. ↑ 3.0 3.1 Goodman CC and Snyder TK. Differential Diagnosis for Physical Therapists: Screening for Referral. 4th edition. St. Louis, Missouri: Saunders Elsevier, 2007.
  4. ↑ 4.0 4.1 National Institute of Mental Health. Health and Outreach: Generalized Anxiety Disorder. http://www.nimh.nih.gov/health/publications/anxiety-disorders/generalized-anxiety-disorder-gad.shtml. Updated July 7, 2009. Accessed February 21, 2010.
  5. ↑ 5.0 5.1 Ballas, Christos, MD. U.S. National Library of Medicine and National Institutes of Health. Medline Plus: Generalized Anxiety Disorder. Updated January 15, 2009. Accessed February 21, 2010.
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