Generalized anxiety disorder differential diagnosis
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Generalized anxiety disorder Microchapters |
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Differentiating Generalized anxiety disorder from other Disorders |
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Diagnosis |
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Treatment |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2]
Overview
The differential diagnosis in generalized anxiety disorder is similar to that of panic disorder. It is important to rule out drug-induced conditions. The mental status examination should take in consideration the possibility of schizophrenia, obsessive-compulsive disorder, major depressive disorder, and both specific and social phobias.
Differential Diagnosis
- Adjustment disorder[1]
- Anxiety disorder due to another medical condition[1]
- Bipolar disorder[1]
- Panic disorder- anxiety is only in regards to having a panic attack
- Post-traumatic stress disorder- presence of flashbacks, hyper-arousal, and hyper-vigilance
- Social phobia- anxiety only occurs in regards to social situations
- Obsessive-compulsive disorder- presence of obsessions and compulsions
- Separation anxiety disorder- anxiety occurs in response to being away from home or family
- Anorexia nervosa- anxiety occurs in response to potentially gaining weight
- Somatization disorder- multiple physical complaints
- Hypochondriasis- anxiety in regards to developing a specific disease
- Schizophrenia- presence of psychotic symptoms such as hallucinations and delusions
- Major depressive disorder- criteria requires two weeks of specific symptoms
- Medications- in particular stimulants such as methylphenidate, pseudoephedrine, and other decongestants or appetite suppressants
- Drug abuse- particularly stimulants and hallucinogenics such as cocaine, caffeine, amphetamines, and PCP
- Drug withdrawal- particularly alcohol withdrawal, benzodiazepine withdrawal, and opiate withdrawal.
- Hyperthyroidism- presence of an elevated TSH on laboratory findings
Differentiating generalized anxiety disorder from other diseases
| Disease | Prominent clinical features | Investigations |
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| Hyperthyroidism | The main symptoms include:
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| Essential hypertension | Most patients with hypertension are asymptomatic at the time of diagnosis. Common symptoms are listed below: | JNC 7 recommends the following routine laboratory tests before initiation of therapy for hypertension:
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| Generalized anxiety disorder | According to DSM V, the following criteria should be present to fit the diagnosis of generalized anxiety disorder:
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| Menopause | The perimenopausal symptoms are caused by an overall drop, as well as dramatic but erratic fluctuations, in the levels of estrogens, progestin, and testosterone. Some of these symptoms such as formication etc may be associated with the hormone withdrawal process.
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| Opioid withdrawal disorder | According to DSM V, the following criteria should be present to fit the diagnosis of opioid withdrawal:
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| Pheochromocytoma | The hallmark symptoms of a pheochromocytoma are those of sympathetic nervous system hyperactivity, symptoms usually subside in less than one hour and they may include:
Please note that not all patients with pheochromocytoma experience all classical symptoms. |
Diagnostic lab findings associated with pheochromocytoma include:
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References
- ↑ 1.0 1.1 1.2 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.