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Generalised anxiety disorder
  1. Christopher Gale1,
  2. Mark Oakley-Browne2
  1. 1Faculty of Medicine and Health Sciences, University of Auckland,
    New Zealand
  2. 2Department of Rural Psychiatry, University of Monash, Victoria, Australia

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The EBMH Notebook summarises key messages about generalised anxiety disorder, sourced from: . For this review, Clinical Evidence Concise searched and appraised material published until June 2003.


Generalised anxiety disorder (GAD) is defined as excessive worry and tension about every day events and problems on most days, for at least six months, to the point where the person experiences distress or has marked difficulty in performing day to day tasks.1 It may be characterised by the following symptoms and signs: increased motor tension (fatigability, trembling, restlessness, and muscle tension); autonomic hyperactivity (shortness of breath, rapid heart rate, dry mouth, cold hands, and dizziness); and increased vigilance and scanning (feeling keyed up, increased startling, and impaired concentration), but not panic attacks.1 One non-systematic review of epidemiological and clinical studies found marked reduction of quality of life and psychosocial functioning in people with anxiety disorders (including GAD).2 It also found that people with GAD have low overall life satisfaction and some impairment in ability to fulfil roles, social tasks, or both.2


One overview of observational studies published in English found that the prevalence of GAD among adults in the community is 1.5–3.0%.3 It found that 3–5% of adults have had GAD in the past year and 4–7% have had GAD during their life. The US National Comorbidity Survey found that over 90% of people diagnosed with GAD had a comorbid diagnosis, including dysthymia (22%), depression (39–69%), somatisation, other anxiety disorders, bipolar disorder, or substance abuse.4 The Harvard Brown Anxiety Research Program also found that only 30/180 (17%) people had GAD …

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