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How to diagnose Generalized Anxiety disorder

Here we will discuss the clinical picture and differential diagnosis of Generalized Anxiety disorder  after we mentioned the causes of Anxiety disorder before .

Clinical Picture 

A- Psychological symptoms 

- Unexplained fears, apprehension, irritability.
- Insomnia, night mares.

B- Somatic manifestations:

CVS: Tachycardia. Lt mammary pain, systolic hypertension.
GIT: Nausea, vomiting, indigestion, diarrhea, anorexia,aerophygia.

Chest: Sighing, tightness, hyperventilation resulting sometimes in tetany & numbness (Hyperventilation
syndrome)
Urogenital: Frequency, dysmenorrhea, impotence, premature ejaculation, sexual frigidity.
Nervous system: Headache, tremors, hyperreflexia.
Muscles: Pains due to muscular spasm.
Skin: Rashes, urticaria, & neurodermatitis

C- Cognitive  manifestations

- Lack of concentration
- Lack of remembering & recall
- Decreased abifity to learn and ability to do ordinary work.

D- Psychosomatic Illness:
- Bronchial asthma, GHD, ulcerative colitis, peptic ulcer.
- Psychosomatic illness usually occur with chronic anxiety .

Differential diagnosis 

- Normal Anxiety : it is a universal feeling, see later.

- Anxiety Symptoms secondary to other psychiatric diseases;
OCD, Mood disorders, substance related disorders. e.g. caffeine intoxication, alcohol and sedatives withdrawal, phobic disorders in which the anxiety is
related to the phobic stimuli.
- Anxiety secondary to medical diseases:
e.g. thyrotoxicosis,pheochromcytoma, mitral valve prolapse, hypoglycemia,angina, bronchial asthma, COPD .

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Tamer Mobarak

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