Approach

The common clinical feature in all patients with GAD is a history of chronic, excessive worry about a life situation for at least 6 months that is out of proportion to any inherent risk, and causes distress and impairment. In adults, at least three key symptoms out of a possible six are required to make a diagnosis (only one is required in children) Fatigue is a common complaint.[1]

GAD is in part a diagnosis of exclusion. Physical health conditions, other mental health disorders, medication side effects, and substance misuse should all be considered in the differential diagnosis. GAD is frequently comorbid with these types of conditions and their presence complicates diagnosis and treatment.[1]

Physical examination and laboratory studies are generally normal if no co-existing physical health problems or substance misuse issues exist. Patients may use healthcare resources excessively to find physical causes for their worry and associated symptoms.

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