Generalized anxiety disorder (GAD) is defined as an anxiety disorder that is characterized by anxiety and nervousness that lacks a clear object and specific content, and is accompanied by significant autonomic symptoms, muscle tension, and motor agitation. Patients suffer from unbearable and unrelieved anxiety.
Anxiety disorders in DSM-IV include generalized anxiety disorder, panic attacks, phobias, obsessive-compulsive disorder, post-traumatic stress syndrome, etc.
I. Diagnostic criteria for generalized anxiety disorder (DSM-IV)
Excessive anxiety and worry about many events or activities (such as work or study) for at least 6 months (apprehensive anticipation) Feeling difficult to control worry, anxiety and worry with at least 3 of the following. Children require only one symptom.
1. Fidgeting or feeling nervous or excited
2.Tiredness easily
3.Hard to concentrate or empty mind
4.Irritability
5.Muscle tension
6, sleep problems (difficult to fall asleep or wake up easily, or can not get a sound and satisfactory sleep)
Anxiety and worry symptoms have various aspects such as
1, anxiety or fear of panic attacks (such as in panic disorder)
2, embarrassed in front of the public (such as in social phobia)
3, contaminated (such as in obsessive-compulsive disorder)
4.Leaving home or loved ones (as in the case of separation anxiety disorder)
5.Weight change (e.g., in anorexia nervosa)
6.Having multiple somatic disorders (e.g., in somatization disorder)
7.Severe illness (e.g., in hypochondriasis)
Anxiety, worry so that somatic symptoms cause distress or impairment of social, occupational, or other important functions. The disorder is not due to a cause (e.g., due to medication, hyperthyroidism, etc.)
II. Clinical manifestations
1. Psychogenic anxiety
Frequent or persistent nervousness and anxiety without a clear object or fixed content, or excessive worry or annoyance about certain problems in real life are the characteristics. This kind of tension and anxiety, worry or annoyance is very disproportionate to reality, making patients feel unbearable but unable to get rid of it. It is often accompanied by sleep disorder and mood control disorder.
2.Somatic anxiety
Autonomic hyperfunction: dry mouth, throat discomfort, panic, sweating, frequent urination, urgent urination, tinnitus, blurred vision, dizziness, etc.
Motor restlessness: restlessness, muscle tremor, shivering, fidgeting, increased purposeless activities, irritability, poor behavioral control, nervous expressions, unnatural movements, pale and sweaty skin, many small movements, inability to sit still, stuttering, and tension muscle pain.
3. Mechanism of anxiety
1.Disorders in the metabolism of neuromodulatory loop mediators.
2, the combined effect of genetics and environment.
Genetic factors determine the individual’s anxiety-related personality traits environmental factors induce, gradually appearing changes in the neurobiochemical aspects of the brain, manifesting mental anxiety; motor anxiety and somatic symptoms.
3.Other neurotransmitter abnormalities