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Anxiety disorders have multiple subtypes each of which is characterized by unnecessary worry that can be distressing to the patient.
Diagnosis is made using the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) also called DSM-IV-TR.
The manual lays down criteria for diagnosis of each of the types of anxiety disorders. If these criteria are fulfilled for at least 6 months, the diagnosis may be made.
Since anxiety disorders often coexist with other psychiatric disorders, diagnosis may be a challenge.
For example, nearly 60% of patients with generalized anxiety disorders have accompanying panic disorder or depressive disorders.
Further the condition may be accompanied with alcohol or drug abuse. (1, 2, 3, 4)
The DSM IV-TR Criteria for Generalized Anxiety Disorder include (1):
The DSM IV-TR criteria for Panic Disorder include (1):
Frequent panic attacks without cause or warning.
There may be presence of agoraphobia (fear of large open spaces). There are no other psychiatric or medial ailments that explain the attacks.
At least a single attack is followed by fear of:
The DSM IV-TR criteria for Post-traumatic stress Disorder include (1):
PTSD patients have a history of experiencing, witnessing or confronting an event that involved treat or actual risk of death or serious harm.
The experience may be accompanied with feelings of fear, helplessness or horror. The feelings of distress persist for at least 1 month.
On presentation the patient may re-live the event by:
Patient avoids or feels at least three of the following:
There may be associated symptoms of anxiety like:
The DSM IV-TR Criteria for Obsessive compulsive Disorder include (1):
Patient has attempted to ignore or suppress such thoughts and recognizes that the obsessional thoughts are a product of his or her own mind.
The compulsions ease the anxiety and reduce distress. These are not realistic and are clearly excessive.
Diagnosing children with an anxiety disorder is difficult. Anxiety in children may manifest as behavioral problems or as a disruptive or rebellious nature.
Exclusion of medical conditions (3) –
Mitral valve prolapse is a disorder where the mitral valve that lies between two chambers of the heart does not close well. This leads to impaired blood flow from the heart and back flow into the left atrium.
There may be symptoms like chest pain, difficulty breathing especially after exercise, fatigue, cough, palpitations etc. this needs to be ruled out.