F41.1 Generalized Anxiety Disorder

The essential feature is anxiety, which is generalized and persistent but not restricted to, or even strongly predominating in, any particular environmental circumstances (i.e. it is "free-floating"). As in other anxiety disorders the dominant symptoms are highly variable, but complaints of continuous feelings of nervousness, trembling, muscular tension, sweating, lightheadedness, palpitations, dizziness, and epigastric discomfort are common. Fears that the sufferer or a relative will shortly become ill or have an accident are often expressed, together with a variety of other worries and forebodings. This disorder is more common in women, and often related to chronic environmental stress. Its course is variable but tends to be fluctuating and chronic.

Diagnostic Guidelines

The sufferer must have primary symptoms of anxiety most days for at least several weeks at a time, and usually for several months. These symptoms should usually involve elements of:

(a) apprehension (worries about future misfortunes, feeling "on edge", difficulty in concentrating, etc.);
(b) motor tension (restless fidgeting, tension headaches, trembling, inability to relax); and
(c) autonomic overactivity (lightheadedness, sweating, tachycardia or tachypnoea, epigastric discomfort, dizziness, dry mouth, etc.).

In children, frequent need for reassurance and recurrent somatic complaints may be prominent.

The transient appearance (for a few days at a time) of other symptoms, particularly depression, does not rule out generalized anxiety disorder as a main diagnosis, but the sufferer must not meet the full criteria for depressive episode, phobic anxiety disorder, panic disorder, or obsessive-compulsive disorder.

Includes:
* anxiety neurosis
* anxiety reaction
* anxiety state

Excludes:
* neurasthenia