generalized anxiety disorder

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Presentation transcript:

generalized anxiety disorder Shehana al-shammmari 111221018

DEFINITION Generalized and persistent anxiety, excessive anxiety or worry (apprehensive expectation) about a number of events (e.g. work, school performance) that the individual finds difficult to control, not restricted to, or predominating in , any particular circumstances (free-floating). lasting for at least six months or longer

organic causes such as thyrotoxicosis, parathyroid disease, AETIOLOGY . Genetic predisposition . Current stress . Life events organic causes such as thyrotoxicosis, parathyroid disease, hypoglycaemia

ASSOCIATIONS/RISK FACTORS Childhood experiences characterised . ° subjective apprehension (fears, worries) ° increased vigilance ° feeling restless and on edge ° sleeping difficulties (initial/middle insomnia, fatigue on waking) ° motor tension (tremor, hyperactive deep reflexes) ° autonomic hyperactivity (e.g. tachycardia). • GAD may be comorbid with other anxiety disorders, depression,alcohol and drug abuse.

EPIDEMIOLOGY Lifetime prevalence is 5%. F > M. Onset is in adolescence to early adulthood. ° generalized anxiety disorder (GAD) (2–4%)

HISTORY The symptoms should be present most days for at least several weeks at a time. These symptoms should involve elements of: . apprehension (worries about future misfortunes, feeling on edge, difficulty concentrating) . motor tension (restlessness, fidgeting, tension headaches, trembling) . autonomic overactivity (sweating, tachycardia or tachypnoea, dizziness, dry mouth).

Tachycardia and tachypnoea. EXAMINATION Tachycardia and tachypnoea.

Differential diagnoses ° excessive caffeine consumption ° depression ° psychotic disorders ° withdrawal from drugs or alcohol

MANAGEMENT Medication - Cognitive behavioral therapy • CBT (self-help material or face to face) for GAD seeks to: Psychoeducation , distraction techniques ,cognitive control , breathing/relaxation techniques Medication - . Benzodiazepines may be useful in the short term. - Other pharmacological treatments include: -beta blocker to control some physical symptoms -° serotonin noradrenaline reuptake inhibitors (SNRIs) -° pregabalin ° buspirone

COMPLICATIONS Half will develop a depressive illness. May misuse alcohol or illicit substances to cope with anxiety.

PROGNOSIS Course may be chronic, worse at times of stress. Poor prognosis is associated with longer duration of illness, co-morbid psychiatric disorder and poor premorbid personality.

summary GAD is persistent anxiety, excessive anxiety or worry Causes of anxiety :- 1-biological 2-environmental 3- integrative perspective 4- brain chemistry Symptoms of anxiety motor tension sleeping difficulties Shortness of breath feeling restless

cont INVESTIGATIONS: FBC, U þ Es, LFTs, Ca, TFTs. MANAGEMENT: CBT medication

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