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Diagnosing GAD (Node 1) David N. Osser, MD, Associate Professor of Psychiatry Harvard Medical School Brockton Division of the VA Boston Healthcare System General Editor - Psychopharmacology Algorithm Project Harvard South Shore Residency Training Program

Algorithm based on studies meeting DSM criteria Node 1: DSM Criteria DSM Algorithm based on studies meeting DSM criteria Note comorbid diagnoses Reinhold, J. A., Mandos, L. A., Rickels, K., & Lohoff, F. W. (2011). Pharmacological treatment of generalized anxiety disorder. Expert opinion on pharmacotherapy, 12(16), 2457-2467. Huh, J., Goebert, D., Takeshita, J., Lu, B. Y., & Kang, M. (2011). Treatment of generalized anxiety disorder: a comprehensive review of the literature for psychopharmacologic alternatives to newer antidepressants and benzodiazepines. The Primary Care Companion to CNS Disorders, 13(2).

GAD in DSM III, DSM–IV, and DSM 5 DSM III, and III-R Autonomic, motor, somatic manifestations of anxiety Under other “anxiety or somatic symptom disorders” in DSM IV & DSM-5 Not relevant to current GAD DSM–IV, and DSM-5 Core problem: excessive worrying Difficult to control, functional impairment Brown, T. A., Barlow, D. H., & Liebowitz, M. R. (1994). The empirical basis of generalized anxiety disorder. The American journal of psychiatry. Goldberg D, Kindler KS, Sirovatka PJ, Regier DA (2010) eds. Diagnostic issues in depression and generalized anxiety disorder.Arlington, VA: American Psychiatric Publishing,

Key Points Medication trial results with DSM-III GAD patients may not be that applicable to patients meeting the current DSM-5 criteria

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