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Differential diagnosis of generalized anxiety disorders

Differential diagnosis of generalized anxiety disorders


Generalized anxiety disorder (GAD) may also cause physical symptoms such as shortness of breath, rapid heart rate, dry mouth, cold hands and dizziness. Other physical illnesses and symptoms that commonly occur along with GAD include chest pain, hyperventilation, chronic fatigue syndrome and irritable bowel syndrome.

The diagnosis of GAD is often complex due to the nature of symptoms, which mimic other mental and physical disorders, as well as comorbid presence of other mental disorders. There are two primary diagnostic tools used by healthcare workers worldwide to detect GAD, including international classification of mental disorder (ICD 10) and Diagnostic and statistical manual of mental disorders (DSM IV). Recent revisions of both ICD 10 and DSM IV have provided healthcare practitioners more accurate and reliable diagnosis of GAD.

DIFFERENTIAL DIAGNOSIS

GAD has to be distinguished from certain other psychiatric and physical disorders. Neurological, endocrinological and medication related disorders must be considered in the differential diagnosis of GAD. Anxiety symptoms may occur in any psychiatric disorder but there are some in which particular diagnostic difficulties arises. The most frequent problem is the distinction between anxiety and depressive disorders because anxiety is a common symptom in depressive disorders and GAD often included some depressive symptoms. The other common co occurring disorders must be explored including panic disorder, phobic disorder and obsessive compulsive disorder.

The physical illnesses which mimic the symptoms of GAD are thyrotoxicosis, pheochromocytoma, hypoglycemia, paroxysmal arrhythmias, brain tumors and temporal lobe epilepsy. Other organic causes for an anxiety syndrome may include stimulant intoxication for caffeine, cocaine or amphetamines; exposure to toxins or withdrawal from sedatives or alcohol.
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