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Generalized anxiety disorder: practical assessment and management.
Michael G Kavan1, Gary Elsasser, Eugene J Barone
1Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA. michaelkavan@creighton.edu
American Family Physician
|February 10, 2010
Summary
Generalized anxiety disorder (GAD) is common in primary care, causing chronic worry and physical symptoms. Cognitive behavior therapy and selective serotonin reuptake inhibitors are effective, with CBT offering potentially more durable results.
Area of Science:
- Primary Care Medicine
- Psychiatry
Background:
- Generalized anxiety disorder (GAD) is a prevalent condition in primary care settings.
- Patients experience excessive, uncontrollable anxiety and worry impacting daily life.
- Physiological symptoms like fatigue and muscle tension are common.
Purpose of the Study:
- To review the diagnosis and management of GAD in primary care.
- To discuss effective treatment options and their comparative durability.
- To highlight factors influencing treatment selection and adherence.
Main Methods:
- Literature review of GAD diagnosis and treatment.
- Analysis of evidence for cognitive behavior therapy (CBT) and pharmacologic agents.
- Consideration of differential diagnoses and contributing factors.
Main Results:
- Selective serotonin reuptuptake inhibitors (SSRIs) and CBT are first-line treatments for GAD.
- CBT demonstrates potentially more durable treatment effects compared to pharmacotherapy.
- Effectiveness of complementary and alternative medicine therapies for GAD is not yet proven.
Conclusions:
- Accurate diagnosis requires considering co-occurring psychiatric and non-psychiatric conditions.
- Treatment selection should prioritize patient preference, adherence, and past treatment success.
- CBT may offer long-term benefits for managing generalized anxiety disorder.
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