Who among the following is most likely to be diagnosed with generalized anxiety disorder?
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Generalized anxiety disorder is diagnosed by a mental health clinician who can help determine whether the symptoms your child is experiencing is related to an anxiety disorder or another medical condition. The mental health clinician (such as a child and adolescent psychiatrist, child psychologist, psychiatric social worker, or psychiatric nurse practitioner) will make the diagnosis following a comprehensive assessment, which includes a
diagnostic with you and your child. During the assessment, parents are asked to talk about their child’s anxiety symptoms and related behavior. You will also be asked to give an overview of your child’s family history, medical history, social history, and social interactions. Sometimes parent or child questionnaires are used to help clarify the diagnosis. After the comprehensive assessment, a mental health clinician will help
explain your child’s condition and answer any questions you or your child may have. The next step is developing a mutually agreed-upon treatment plan that works for you, your child, and your family. If you suspect your child may have GAD, it is essential to speak with a qualified mental health professional as soon as possible. Children with GAD respond well to treatment that is administered by trained mental health clinicians. By closely
working with the treatment team, you can help your child go on to enjoy an active and fulfilling life. Evidence-based treatments for GAD in children and adolescents includes cognitive behavioral therapy, medication, or a combination of medication and therapy. Here at Boston Children’s Hospital, medication is used in conjunction with therapy for treatment of GAD. Selective serotonin reuptake inhibitor (SSRI) antidepressants are currently first-line medications in the pharmacotherapy of
anxiety disorders in children. These antidepressants are powerful anxiolytics with a broader spectrum that may improve comorbid affective disorders and symptoms of anxiety. What is the long-term outlook for a child with GAD?If left untreated, studies show that GAD is often a chronic illness with symptoms that tend to wax and wane across the lifespan. Earlier age of onset is also associated with greater risk for development of other anxiety and depressive disorders later in life.
SymptomsGeneralized anxiety disorder, or GAD as it is more commonly referred to, is an anxiety disorder characterized by excessive worry or apprehension displayed across a variety of everyday situations or activities. Patients with GAD worry about things that most people will from time to time worry about, such as health, finances, work difficulties, or family problems. However, while most people are able to control their anxiety regarding these issues, those with GAD are unable to stop focusing on these everyday issues, often fearing the worst outcome for every situation for which they’re experiencing anxiety. Quite often the worry of GAD patients is out of proportion to the actual likelihood of their feared outcome. For instance, someone might be unable to stop worrying that they are not performing well at work and will soon be fired from their position, despite a complete lack of evidence that their job performance has been poor. GAD patients describe their anxiety as being constantly present in their daily lives. In addition to the uncontrollable worry, GAD patients also experience a variety of arousal symptoms, such as restlessness, difficulty concentrating, irritability, and being easily fatigued. Sometimes, GAD patients experience physiological symptoms as a result of their constant state of apprehension. These can include nausea, headaches, and dry mouth among others. Generalized anxiety disorder causes its sufferers great distress and trouble functioning in several different areas, such as at work, at home with family, or when out socially with friends. Common SymptomsAccording to the Diagnostic and Statistical Manual, Fifth Edition (DSM-5), the following criteria must be met in order for a person to receive a diagnosis of generalized anxiety disorder.
GAD in ChildrenFor children suffering from GAD, the worries tend to be focused on either competence or quality of performance at school or in sporting events. Occasionally, children may focus their anxiety on the occurrence of catastrophic events such as earthquakes or nuclear war. Children with GAD may be appear to be perfectionists and might require excessive reassurance or approval from adults regarding the quality of their work. Back to Top Onset and CourseWhile generalized anxiety disorder can occur at any age, many individuals with GAD report feeling anxious all their lives. While no there is no known specific cause for the disorder, research suggests that there may be a genetic component involved in GAD, with individuals having family members with the disorder more likely to develop GAD than those in the general population. While no specific causing gene has been located, research now indicates that biology, environment, and life experience may all play a role in the development and course of GAD. While the median age of onset is 30 years, a very broad range exists for the spread of age at time of onset. Patients reporting a later onset of their GAD typically will say their symptoms developed in response to a significant stressful event in their lives. Once an individual develops GAD, the course of the disorder is most often chronic. The severity of symptoms may fluctuate and worsen during times of stress. Epidemiological InformationThe 12-month prevalence of generalized anxiety disorder is 0.9% among adolescents and 2.9% among adults in the general community of the U.S. The 12-month prevalence for the disorder in other countries ranges from 0.4% to 3.6%. Individuals of European descent tend to experience GAD more frequently than do individuals of non-European descent (i.e. Asian, African, Native American and Pacific Islander). Furthermore, individuals from developed countries are more likely than individuals from developing countries to report that they have experienced symptoms that meet criteria for GAD in their lifetime. Back to Top Co-Occurrence with Other DisordersGeneralized anxiety disorder often may be accompanied by other anxiety or unipolar depressive disorders, such as major depression, dysthymia, panic disorder, or social anxiety disorder. Recent research on co-occurring anxiety and depression has shown that individuals suffering from both disorders are more likely to have greater symptom severity and a lower response to treatment than those presenting with only one disorder. Also, patients with dual diagnoses show greater impairment in social function and quality of life. Research has also demonstrated an overlap in genetic and environmental risk factors between these disorders; however, independent pathways are also possible. Co-occurrence with substance use, conduct, and psychotic disorders is less common. In addition to occurring alongside other mental disorders, patients with GAD may also suffer from other physical conditions as a result of their constant anxiety, such as irritable bowel syndrome. Doctors seeing patients with chronic physical complaints who also report continuous feelings of worry and anxiety may be likely to recognize this as GAD and make an appropriate mental health referral. What age group is most affected by generalized anxiety disorder?Data from the National Health Interview Survey
The percentage of adults who experienced mild, moderate, or severe symptoms of anxiety was highest among those aged 18–29 and decreased with age. Women were more likely to experience mild, moderate, or severe symptoms of anxiety than men.
Who commonly gets anxiety disorders?Who gets anxiety disorders? Anxiety disorders most often start when people are teenagers. Anyone can get one, but they are more common among women and girls. They are also more common in people who were neglected/abused as children, or who are neglected/abused as adults.
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