Assessment methods and the differential diagnosis of anxiety

Anxiety states are commonly encountered, especially in general practice. Some endocrine disorders have features in common with anxiety states, especially thyrotoxicosis and idiopathic hypoglycemia. Functional cardiovascular disorders merge into anxiety states and include a large number of ill-differentiated syndromes. Other causes of anxiety are the drug-associated conditions, such as amphetamine overdose and barbiturate withdrawal. Among neuropsychiatric illnesses, temporal lobe epilepsy and the postconcussional state commonly have anxiety as a prominent syndrome. Psychophysiological technique can be used to assess anxiety levels in a variety of clinical contexts but need cautious interpretation. Anxiety is most easily assessed using rating scales but potential users must be clear as to what they are trying to measure. For clinical anxiety assessed by the physician, the Hamilton Scale is appropriate; for self-assessments linear scales can be adapted.