Generalised anxiety disorder

Generalised anxiety disorder is a syndrome of ongoing anxiety and worry about many events or thoughts that the patient generally recognises as excessive and inappropriate. However, the nature of “generalised worry” has been hard to describe in a categorical manner. The criteria required for making a diagnosis are evolving: these criteria clearly increase or decrease markedly the threshold for diagnosis.1 #### SUMMARY POINTS About 1%-5% of the general population report having generalised anxiety disorder. Many of these people also have other disorders, and those with generalised anxiety disorder report a considerable level of disability. Long term follow-up studies suggest that generalised anxiety disorder is a condition that worsens the prognosis for any other condition, and that people who have only generalised anxiety disorder are likely to develop further conditions. The availability of and evidence for efficacious treatments has increased in the past five years. We used the Clinical Evidence database2 then searched for community surveys, randomised controlled trials, and systematic reviews—using the term “generalised anxiety disorder”—in Medline, Embase, and the Cochrane Library up to June 2006. Most of the recent literature uses DSM-IV criteria for generalised anxiety disorder; the ICD-10 criteria place greater weight on somatic symptoms and explicitly limit comorbidity (box). #### Current diagnostic criteria for generalised anxiety disorder ##### Diagnostic and statistical manual of mental disorders (DSM-IV-TR)