小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 过分担心,持续至少6个月
- 不完全符合另一种精神障碍的焦虑
- 焦虑不是有因使用药物或物质滥用所致
- 肌肉紧张
- 睡眠障碍
- 疲劳
- 多动
- 易怒
- 注意力不集中
其他诊断因素
- 头痛
- 出汗
- 头晕
- 胃肠道症状
- 肌肉疼痛
- 心率加快
- 呼吸短促
- 发抖
- 过度的惊吓反应
- 胸痛
危险因素
- 焦虑家族史
- 躯体或精神压力
- 躯体、性或情感创伤史
- 其他类型焦虑障碍
- 慢性躯体疾病
- 女性
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 甲状腺功能检测
- 尿液药物筛查
- 24 小时尿液儿茶酚胺、甲氧基肾上腺素、甲氧基去甲肾上腺素和肌酐检测
- 肺功能检查 (PFT)
- 心电图 (ECG)
治疗流程
焦虑症状符合 DSM-5-TR 标准
焦虑症状不符合 DSM-5-TR 标准
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 has acted as an expert witness in medico-legal cases involving anxiety and depressive disorders and their treatment. He is a member of the British Association for Psychopharmacology.
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.
同行评议者
Lori Davis, MD
Research Director
University of Alabama
School of Medicine Tuscaloosa Campus
College of Community Health Sciences
Tuscaloosa
AL
利益声明
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
利益声明
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
利益声明
EL declares that she has no competing interests.
鉴别诊断
- 惊恐障碍
- 社会焦虑障碍
- 强迫症
更多 鉴别诊断指南
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- 妊娠期和产后心理健康疾病的治疗和管理
更多 指南患者教育信息
何为焦虑?
焦虑:如何有效治疗?
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