Anxiety physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

The diagnosis of anxiety is mostly clinical, based on a thorough history and physical exam. Some of the physical exam findings in anxiety are tremor, tachycardia, twitches, sweating, restlessness.

Physical examination

• The following are the some of the physical examination findings associated with anxiety disorders:

Appearance of the patient

• The patient appears panicky, restless, anxious

HEENT

• Dry mouth

Extremities

• Cold, sweaty, tingling of hands and feet

Respiratory

• Shortness of breath

Cardiovascular

• Tachycardia, palpitations

Musculoskeletal

• Tense muscles

Central nervous system

• Dizziness

Mental status examination

Complete mental status examination should be obtained for each patient with anxiety symptoms, assessing appearance, behavior, ability to cooperate with the exam, level of activity, speech, mood and affect, thought processes and content, insight, and judgment. Patients are generally oriented times 3 and cooperative. Mood may be normal or depressed. Affect is often preserved. Psychotic symptoms are not typical of uncomplicated anxiety disorders. Suicidal ideation should be assessed by asking about passive thoughts of death, desires to be dead, thoughts of harming self, or plans or acts to harm self. Homicidal ideation is uncommon. Cognition is typically intact with no impairment in memory, language, or speech. Insight and judgment are typically intact.