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Anxiety disorder

Anxiety disorder
The Scream (Norwegian: Skrik) a painting by Norwegian artist Edvard Munch[1]
SpecialtyPsychiatry, clinical psychology
SymptomsWorrying, fast heart rate, shakiness[2]
ComplicationsDepression, trouble sleeping, poor quality of life, substance use disorder, alcohol use disorder, suicide[3]
Usual onset15–35 years old[4]
DurationOver 6 months[2][4]
CausesGenetic, environmental, and psychological factors[5]
Risk factorsChild abuse, family history, poverty[4]
Diagnostic methodPsychological assessment
Differential diagnosisHyperthyroidism; heart disease; caffeine, alcohol, cannabis use; withdrawal from certain drugs[4][6]
TreatmentLifestyle changes, counselling, medications[4]
MedicationSSRIs and SNRIs are first line,[7] other options include: tricyclic antidepressants, benzodiazepines, beta blockers[5]
Frequency12% per year[4][8]

Anxiety disorders are a group of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired.[2] Anxiety may cause physical and cognitive symptoms, such as restlessness, irritability, easy fatigue, difficulty concentrating, increased heart rate, chest pain, abdominal pain, and a variety of other symptoms that may vary based on the individual.[2]

In casual discourse, the words anxiety and fear are often used interchangeably. In clinical usage, they have distinct meanings; anxiety is clinically defined as an unpleasant emotional state for which the cause is either not readily identified or perceived to be uncontrollable or unavoidable, whereas fear is clinically defined as an emotional and physiological response to a recognized external threat.[9] The umbrella term 'anxiety disorder' refers to a number of specific disorders that include fears (phobias) and/or anxiety symptoms.[2]

There are several types of anxiety disorders, including generalized anxiety disorder, hypochondriasis, specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism.[2] Individual disorders can be diagnosed using the specific and unique symptoms, triggering events, and timing.[2] A medical professional must evaluate a person before diagnosing them with an anxiety disorder to ensure that their anxiety cannot be attributed to another medical illness or mental disorder.[2] It is possible for an individual to have more than one anxiety disorder during their life or to have more than one anxiety disorder at the same time.[2] Comorbid mental disorders or substance use disorders are common in those with anxiety. Comorbid depression (lifetime prevalence) is seen in 20-70% of those with social anxiety disorder, 50% of those with panic disorder and 43% of those with general anxiety disorder. The 12 month prevalence of alcohol or substance use disorders in those with anxiety disorders is 16.5%.[7]

Worldwide, anxiety disorders are the second most common type of mental disorders after depressive disorders.[10] Anxiety disorders affect nearly 30% of adults at some point in their lives, with an estimated 4% of the global population currently experiencing an anxiety disorder. However, anxiety disorders are treatable, and a number of effective treatments are available.[11] Most people are able to lead normal, productive lives with some form of treatment.[12]

  1. ^ Aspden P (20 April 2012). "So, what does 'The Scream' mean?". Financial Times. ProQuest 1008665027.
  2. ^ a b c d e f g h i Diagnostic and statistical manual of mental disorders 5th edition: DSM-5. Arlington, VA Washington, D.C.: American Psychiatric Association. 2013. p. 189–195. ISBN 978-0-89042-555-8. OCLC 830807378.
  3. ^ "Anxiety disorders – Symptoms and causes". Mayo Clinic. Retrieved 23 May 2019.
  4. ^ a b c d e f Cite error: The named reference Lancet2016 was invoked but never defined (see the help page).
  5. ^ a b "Anxiety Disorders". National Institute of Mental Health (NIMH). U.S. National Institutes of Health. March 2016. Archived from the original on 27 July 2016. Retrieved 14 August 2016.
  6. ^ Cite error: The named reference Test2013partIII was invoked but never defined (see the help page).
  7. ^ a b Szuhany KL, Simon NM (27 December 2022). "Anxiety Disorders: A Review". JAMA. 328 (24): 2431–2445. doi:10.1001/jama.2022.22744. PMID 36573969.
  8. ^ Kessler RC, Angermeyer M, Anthony JC, DE Graaf R, Demyttenaere K, Gasquet I, et al. (October 2007). "Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative". World Psychiatry. 6 (3): 168–176. PMC 2174588. PMID 18188442.
  9. ^ Pharmacological treatment of mental disorders in primary health care. World Health Organization. 2009. hdl:10665/44095. ISBN 978-92-4-154769-7.[page needed]
  10. ^ Vos T, Abajobir AA, Abate KH (September 2017). "Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016". The Lancet. 390 (10100): 1211–1259. doi:10.1016/S0140-6736(17)32154-2. PMC 5605509. PMID 28919117.
  11. ^ "Anxiety disorders". World Health Organization.
  12. ^ "What are Anxiety Disorders?". American Psychiatric Association.

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