小结
定义
病史和体格检查
关键诊断因素
- presença de fatores de risco
- preocupação excessiva que dura há, pelo menos, 6 meses
- ansiedade não limitada a outro transtorno mental
- ansiedade não decorrente de medicamento ou substância
- tensão muscular
- perturbação do sono
- fadiga
- sono agitado
- irritabilidade
- baixa concentração
其他诊断因素
- cefaleia
- sudorese
- tontura
- sintomas gastrointestinais
- dores musculares
- frequência cardíaca aumentada
- dispneia
- tremores
- resposta de sobressalto exagerada
- dor torácica
危险因素
- história familiar de ansiedade
- estresse emocional ou físico
- história de trauma emocional, físico ou sexual
- outro transtorno de ansiedade
- doença física crônica
- sexo feminino
诊断性检查
首要检查
- diagnóstico clínico
需考虑的检查
- testes da função tireoidiana
- exame de urina para detecção de drogas
- urina de 24 horas para catecolaminas, metanefrinas, normetanefrinas e creatinina
- testes de função pulmonar
- eletrocardiograma (ECG)
治疗流程
sintomas de ansiedade que satisfazem os critérios do DSM-5-TR
sintomas de ansiedade que não preenchem os critérios do DSM-5-TR
撰稿人
作者
Philip John Cowen, MD, FRCPsych, FMedSci
Professor of Psychopharmacology
Department of Psychiatry
University of Oxford
Oxford
UK
利益声明
PJC declares that he has no competing interests.
鸣谢
Professor Philip John Cowen would like to gratefully acknowledge Dr Christopher Gale, Dr Richard P. Swinson, Dr Elizabeth Hoge, and Dr Phebe Tucker, previous contributors to this topic.
利益声明
CG is an author of the Royal Australian and New Zealand College of Psychiatrists clinical practice guideline on social phobia, panic disorder, and generalised anxiety disorder. Otago University has commercial and research relationships with multiple pharmaceutical companies. He is an author of a number of references cited in this topic. RPS has personally received royalties for articles published in UpToDate (Wolters Kluwer) and the Compendium of Therapeutic Choices, 2nd edition (Canadian Pharmacists Association). EH is an author of a number of references cited in this topic. PT has conducted research for GlaxoSmithKline, Bristol-Myers Squibb, Wyeth Pharmaceuticals, Astra-Zeneca, Cephalon, Inc., and Ortho-McNeil. She has also consulted for Forest Pharmaceuticals and received honoraria from Pfizer, Inc. and Forest Pharmaceuticals.
Peer reviewers
Lori Davis, MD
Research Director
University of Alabama
School of Medicine Tuscaloosa Campus
College of Community Health Sciences
Tuscaloosa
AL
Disclosures
LD declares that she has no competing interests.
Arianna Di Florio, MD, PhD
Senior Clinical Lecturer
Division of Psychological Medicine and Clinical Neurosciences
Cardiff University
United Kingdom
Disclosures
ADF declares that she has no competing interests.
Elaine Lockhart, MD, BCH, BAO
Consultant in Paediatric Liaison Psychiatry
Royal Hospital for Children
Glasgow
United Kingdom
Disclosures
EL declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
Bandelow B, Sher L, Bunevicius R, et al; WFSBP Task Force on Mental Disorders in Primary Care; WFSBP Task Force on Anxiety Disorders, OCD and PTSD. Guidelines for the pharmacological treatment of anxiety disorders, obsessive-compulsive disorder and posttraumatic stress disorder in primary care. Int J Psychiatry Clin Pract. 2012 Jun;16(2):77-84. Abstract
Bandelow B, Sagebiel A, Belz M, et al. Enduring effects of psychological treatments for anxiety disorders: meta-analysis of follow-up studies. Br J Psychiatry. 2018 Jun;212(6):333-8.Full text Abstract
Slee A, Nazareth I, Bondaronek P, et al. Pharmacological treatments for generalised anxiety disorder: a systematic review and network meta-analysis. Lancet. 2019 Feb 23;393(10173):768-77. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Transtorno de pânico
- Transtorno da ansiedade social
- Transtorno obsessivo-compulsivo
More DifferentialsGuidelines
- Treatment and management of mental health conditions during pregnancy and postpartum
- Generalised anxiety disorder and panic disorder in adults: management
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