Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- 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
Outros fatores diagnósticos
- cefaleia
- sudorese
- tontura
- sintomas gastrointestinais
- dores musculares
- frequência cardíaca aumentada
- dispneia
- tremores
- resposta de sobressalto exagerada
- dor torácica
Fatores de risco
- história familiar de ansiedade
- estresse emocional ou físico
- história de trauma emocional, físico ou sexual
- outro transtorno de ansiedade
- doença física crônica
- sexo feminino
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- diagnóstico clínico
Investigações a serem consideradas
- 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)
Algoritmo de tratamento
sintomas de ansiedade que satisfazem os critérios do DSM-5-TR
sintomas de ansiedade que não preenchem os critérios do DSM-5-TR
Colaboradores
Autores
Philip John Cowen, MD, FRCPsych, FMedSci
Professor of Psychopharmacology
Department of Psychiatry
University of Oxford
Oxford
UK
Declarações
PJC declares that he has no competing interests.
Agradecimentos
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.
Declarações
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.
Revisores
Lori Davis, MD
Research Director
University of Alabama
School of Medicine Tuscaloosa Campus
College of Community Health Sciences
Tuscaloosa
AL
Declarações
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
Declarações
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
Declarações
EL declares that she has no competing interests.
Referências
Principais artigos
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. Resumo
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.Texto completo Resumo
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. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Transtorno de pânico
- Transtorno da ansiedade social
- Transtorno obsessivo-compulsivo
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