Generalized Anxiety Disorder (GAD) is mental disorder characterized by excessive anxiety and worry about multiple events or activities (e.g. - school or work difficulties, relationships, finances) on a majority of days over at least half a year. There are also associated symptoms, such as restlessness, muscle tension, fatigue, poor concentration, irritability, and sleep changes.
Excessive 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).
The individual finds it difficult to control the worry.
The anxiety and worry are associated with at least 3
of the 6 symptoms (with at least some symptoms present for more days than not for the past 6
months);
1
item is required in children
BESKIM
can be used to remember the criteria for generalized anxiety disorder.B
- Blank mind E
- Easily fatigued S
- Sleep disturbanceK
- Keyed Up/Restless/On-edgeI
- Irritability M
- Muscle tension The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The 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 disturbance is not better explained by another mental disorder:
Specify if:
4
of the following symptoms occur (Note: The abrupt surge can occur from a calm state or an anxious state):Name | Rater | Description | Download |
---|---|---|---|
Generalized Anxiety Disorder 7 (GAD-7) | Patient | The GAD-7 is a 7-item self-reported questionnaire for screening and a severity measure of generalized anxiety disorder | Download |
Beck Anxiety Inventory (BAI) | Patient | The BAI is a 21-question self-report inventory for screening and a severity measure of generalized anxiety disorder | Download |
3
months of the onset of the stressor and does not persist for more than 6
months after the termination of the stressor.1st line | Monotherapy: agomelatine, duloxetine, escitalopram, paroxetine, paroxetine CR, pregabalin, sertraline, venlafaxine XR |
---|---|
2nd line | Monotherapy: alprazolam*, bromazepam*, bupropion XL*, buspirone, diazepam*, hydroxyzine, imipramine, lorazepam*, quetiapine XR*, vortioxetine |
3rd line | Monotherapy: citalopram, divalproex chrono, fluoxetine, mirtazapine, trazodone |
Adjunctive therapy | Second-line: pregabalin Third-line: aripiprazole, olanzapine, quetiapine, quetiapine XR, risperidone Not recommended: ziprasidone |
Not recommended | Beta blockers (propranolol), pexacerfont, tiagabine |
Guideline | Location | Year | Website | |
---|---|---|---|---|
Canadian Clinical Practice Guidelines for the Management of Anxiety, Posttraumatic Stress and Obsessive-Compulsive Disorders | Canada | 2014 | - | Link |
Canadian Network for Mood and Anxiety Treatments (CANMAT) | Canada | 2012 | - | Link |
National Institute for Health and Care Excellence (NICE) | UK | 2011, 2019 | - | Link |
Royal Australian and New Zealand College of Psychiatrists (RANZCP) | AUS, NZ | 2018 | - | Link |