Generalized anxiety disorder – contemporary intervention

Abstract

Introduction. Anxiety disorders are the most commonly encountered type of psychiatric disorders. Many patients with anxiety disorders report physical symptoms related to anxiety and then seek primary healthcare provider consultations. The pathogenesis of anxiety disorders is multifactorial, involving complex interactions between biological factors, environmental influences, and psychological mechanisms. Despite the high prevalence rates of generalized anxiety disorder, it is often underdiagnosed. Aim of study. To identify the level of generalized anxiety in individuals seeking primary healthcare for various somatic problems. Methods and materials. Articles published between 2010 and 2023 were studied on platforms such as PubMed, Mendeley, and Google Scholar. Results. Generalized Anxiety Disorder (GAD) involves repeated feelings of nervousness, intense worries related to real situations or events, accompanied by symptoms such as fatigue, difficulty concentrating, and/or sleep disturbances. These manifestations must persist for at least 6 months. One of the primary risk factors is gender, which plays a certain role in the onset and progression of generalized anxiety disorder, with women having a risk 1.5 to 2 times higher than men to receive a diagnosis of anxiety disorder. Another risk factor is age; GAD is more commonly found in individuals aged 18 to 65, but it often begins in young individuals around 30 years old. Among patients with moderate to severe anxiety, those employed predominated, indicating that occupational status is a risk factor for GAD due to environmental factors affecting mental health, such as tense social relationships in the professional environment, society, low social support, or poverty, unemployment, discrimination, and human rights violations. Another significant risk factor is comorbidities; cardiovascular conditions such as hypertension, cardiomyopathies; digestive conditions such as chronic gastritis, pancreatitis, chronic cholecystitis; and endocrine conditions such as diabetes and hypothyroidism prevail. Screening tools such as GAD-7 are used to diagnose this disorder, and other instruments assess the severity of symptoms. Cognitive-behavioral therapy and exposure therapy to anxiety-provoking factors prove to be effective in GAD from mild to moderate. Selective serotonin reuptake inhibitors are first-line treatments in more severe forms with a response rate of 30 to 50%. Conclusion. Generalized anxiety disorder proves to be a health problem affecting daily life, also involving considerable medical costs. Without treatment, patients may experience other conditions such as depression, social phobia, and separation anxiety disorder.