1/21/2024 0 Comments Lama hasan ageThe disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep). Restlessness or feeling keyed up or on edge.ĭifficulty concentrating or mind going blank. Note: Only one item is required in children. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months): The individual finds it difficult to control the worry. Systematic review of low- to moderate-quality RCTs and low-quality RCTsĮxcessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). Physical activity reduces symptoms of anxiety. ![]() Psychotherapy can be as effective as medication for GAD and PD for PD, evidence of benefit is strongest for cognitive behavior therapy. Systematic review data and NICE guidelines Systematic review of double-blind RCTs, review article, and guidelineīenzodiazepines are not more effective than anti-depressants for anxiety disorders and should not be used as first-line therapy. Systematic review data and NICE guidelineĪntidepressants should be continued for at least six to 12 months after achieving treatment response to decrease the rate of relapse. SSRIs and SNRIs are recommended as first-line medications for treating GAD and PD. Systematic review, NICE guidelines, and USPSTF recommendation evaluating accuracy of tools but not on improving patient outcomes when used for screening There is insufficient evidence supporting universal screening for GAD in the general adult population. No consistent evidence currently supports a specific prevention strategy for PD or GAD, but exercise may be beneficial. ![]() Benzodiazepines are not recommended for first-line therapy or long-term use because of adverse reactions, risk of dependence, and higher mortality. Effective therapies for PD and GAD include cognitive behavior therapy and anti-depressants, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. ![]() Anxiety disorders often present with substance use disorders, which should be treated concurrently. The GAD-7 and Patient Health Questionnaire for PD are validated screening tools that can aid in diagnosis and assessment. Although there is insufficient evidence to support universal screening for PD and GAD, evaluation should be considered in patients who express recurrent, pervasive worry or present with somatic symptoms not attributed to underlying medical conditions. Generalized anxiety disorder (GAD) and panic disorder (PD) are common mental health conditions in adults that are often seen in primary care.
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