anxiety
ANXIETY

Anxiety disorders are disorders wherein the patient experiences uncontrollable fear or anxiety with behavioral disturbances that affects normal functioning.

Generalized anxiety disorder is having excessive anxiety and worry occurring for at least 6 months about several events or activities. The person finds it difficult to control the worry.
Panic disorder is when the person experienced recurrent unexpected panic attacks.
Social anxiety disorder is marked and persistent fear of social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others.

Introduction

  • Disorders that have common features of excessive fear and anxiety with related behavioral disturbances
  • They commonly coexist with depressive symptoms especially in patients with severe anxiety

Signs and Symptoms

Generalized Anxiety Disorder

  • Patient experiences persistent and excessive anxiety and worry about various domains, including work and school performance, that the patient had difficulty in controlling 
  • Symptoms that commonly occur are:
    • Multiple unexplained bodily symptoms
    • Insomnia
    • Irritability, muscle spasm
    • Restlessness
    • Easy fatigability
    • Difficulty concentrating

Panic Disorder 

  •  Patient experiences recurrent unexpected panic attacks and is persistently concerned or worried about having more panic attacks or the patient changes his/her behavior in maladaptive ways due to the panic attacks
  • Symptoms that commonly occur are:
    • Dizziness
    • Chest pain or discomfort, shortness of breath
    • Palpitations or tachycardia
    • Nausea, gastrointestinal upset
    • Trembling, sweating, hot flushes, chills

Social Anxiety Disorder

  •  Patient is fearful or anxious about or avoids social interactions and/or performance situations that involve the possibility of being scrutinized
  • Symptoms that commonly occur are:
    • Blushing
    • Sweating
    • Palpitations
    • Fear is so great that it interferes with normal functioning, relationships, social activities, or there is excessive distress concerning the phobia

Epidemiology

General Anxiety Disorder

  • Prevalence is 0.9% among adolescents and 2.9% in adults in the general population of the United States
    • While prevalence in other countries ranges from 0.4%-3.6%
    • Lower incidence among Asians, Africans, native Americans and Pacific Islander compared to Europeans
  • Morbidity risk is 9%
  • Usually occurs in middle aged individuals
  • Ratio of occurrence in females than males is 2:1
Panic Disorder
  • Prevalence is estimated to be 2%-3% in adults and adolescents in the general population across the United States and several European countries
    • Lower rates among Latinos, African Americans, Caribbean blacks and Asian Americans
    • Higher rates among American Indians and non-Latino whites
  • Prevalence is estimated to be 0.1%-0.8% in Asia, Africa and Latin American countries
  • Ratio of occurrence in females than males is 2:1
  • Low prevalence rates in children <14 years of age
    • Peak prevalence during adulthood and declines in individuals >64 years of age
Social Anxiety Disorder
  • Prevalence rate in United States is approximately 7% while in Europe is 2.3%
  • There is comparable prevalence rates in children and adolescents with rates decrease with age
  • Prevalence rates among adults ranges from 2%-5%
  • Odds ratio of females than in males range from 1.5-2.2
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