Generalized anxiety disorder diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Irfan Dotani

Overview

The criteria for generalized anxiety disorder include at least 6 months of excessive anxiety or worry, about a number of situations, which is difficult to control. The worry may also be associated with three of the following symptoms; restlessness. fatigue, irritability, muscle tension, poor sleep, and difficulty concentrating.

Diagnostic Criteria

DSM-V Diagnostic Criteria for Generalized Anxiety Disorder[1]

  • A. 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).

AND

  • B. The individual finds it difficult to control the worry.

AND

C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months);[2]

Note: Only one item is required in children.

AND

  • D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.[3]

AND

AND

reminders of traumatic events in post traumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder).

DSM-IV Diagnostic Criteria for Generalized Anxiety Disorder

According to the Diagnostic and Statistical Manual IV-Text Revision (DSM-IV-TR), the following criteria must be met for a person to be diagnosed with Generalized Anxiety Disorder.

  1. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least six months, about a number of events or activities (such as work or school performance).
  2. The person finds it difficult to control the worry.
  3. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months). Note: Only one item is required in children.[4]
    1. Restlessness or feeling keyed up or on edge
    2. Being easily fatigued
    3. Irritability
    4. Muscle tension
    5. Difficulty falling or staying asleep, or restless unsatisfying sleep
    6. Difficulty concentrating or the mind going blank
  4. The focus of the anxiety and worry is not confined to features of an Axis I disorder, e.g., the anxiety or worry is not about having a panic attack (as in panic disorder), being embarrassed in public (as in social phobia), being contaminated (as in obsessive-compulsive disorder), being away from home or close relatives (as in separation Anxiety Disorder), gaining weight (as in anorexia nervosa), having multiple physical complaints (as in somatization disorder), or having a serious illness (as in hypochondriasis), and the anxiety and worry do not occur exclusively during post-traumatic stress disorder.
  5. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  6. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.

References

  1. Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
  2. Hartley CA, Phelps EA (2012). "Anxiety and decision-making". Biol Psychiatry. 72 (2): 113–8. doi:10.1016/j.biopsych.2011.12.027. PMC 3864559. PMID 22325982.
  3. Kessler RC, Angermeyer M, Anthony JC, DE Graaf R, Demyttenaere K, Gasquet I; et al. (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): 168–76. PMC 2174588. PMID 18188442.
  4. Zald DH, Pardo JV (1997). "Emotion, olfaction, and the human amygdala: amygdala activation during aversive olfactory stimulation". Proc Natl Acad Sci U S A. 94 (8): 4119–24. PMC 20578. PMID 9108115.