Introduction
- Disorders that have common features of excessive fear and anxiety with related behavioral disturbances
- They commonly coexist with depressive symptoms or major depressive disorder 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
- Patient had difficulty in controlling almost everyday
- 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; it has episodic characteristics
- 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