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جمعه, ۲۳ آذر , ۱۳۹۷

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Everyone feels anxious now and then. It’s a normal emotion. Many people feel nervous when faced with a problem at work, before taking a test, or making an important decision.Anxiety disorders are different, though. They can cause such distress that it interferes with your ability to lead a normal life

This type of disorder is a serious mental illness. For people who have one, worry and fear are constant and overwhelming, and can be disabling. But with treatment, many people can manage those feelings and get back to a fulfilling life

In May 2013, the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders, or the DSM-5 for short, was released by the American Psychiatric Association. The DSM-5 serves as a reference for qualified mental health providers to make a diagnosis of Generalized Anxiety Disorder (GAD) and other psychiatric conditions

?What are the symptoms
:The DSM-5 criteria for GAD are as follows

The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months and is clearly excessive

Excessive worry means worrying even when there is nothing wrong, or in a manner that is disproportionate to actual risk. This typically involves spending a high percentage of waking hours worrying about something. The worry may be accompanied by reassurance-seeking from others

In adults, the worry can be about job responsibilities or performance, one’s own health or the health of family members, financial matters, and other everyday, typical life circumstances. Of note, in children, the worry is more likely to be about their abilities or the quality of their performance (for example, in school)

The worry is experienced as very challenging to control
Worry in both adults and children may shift from one topic to another

The anxiety and worry is associated with at least 3 of the following physical or cognitive symptoms (In children, only 1 symptom is necessary for a diagnosis of GAD)
Edginess or restlessness
Tiring easily; more fatigued than usual
Impaired concentration or feeling as though the mind goes blank
Irritability (which may or may not be observable to others)
Increased muscle aches or soreness
Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep)

Many individuals with GAD also experience symptoms such as sweating, nausea or diarrhea

The anxiety, worry, or associated symptoms make it hard to carry out day-to-day activities and responsibilities. They may cause problems in relationships, at work, or in other important areas
These symptoms are unrelated to any other medical conditions and cannot be explained by the effect of substances including a prescription medication, alcohol or recreational drugs
These symptoms are not better explained by a different mental disorder

:References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (Fifth edition). Washington, D.C.: American Psychiatric Association; 2013

Brown, TA, Barlow DH. Treatments that Work: Anxiety and Related Disorders Interview Schedule for DSM-5. New York: Oxford University Press, 2014.

First MB, Spitzer RL, Gibbon M, Williams JB. Structured Clinical Interview for DSM-IV (SCID). New York: Biometrics Research, New York State Psychiatric Institute; 1998. [DSM-5 version pending publication by the American Psychiatric Association: http://www.scid4.org/index.html]

Silverman WK, Albano AM. Anxiety Disorders Interview Schedule for DSM-IV: Child Version, child and parent interview schedules. San Antonio, TX, Psychological Corporation, 1996

Spitzer RL, Kroenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006;166:1092-1097

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