Anxiety Disorder Due to a General Medical Condition

2020 ◽  
Author(s):  

Author(s):  
Ambreen Ghori ◽  
Aarti Gupta

This chapter reviews topics on anxiety disorders including panic disorder, specific phobia, social anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, generalized anxiety disorder, anxiety disorder due to a general medical condition, Substance/medication-induced anxiety disorder and body dysmorphic disorder





Author(s):  
Gina Magyar-Russell ◽  
Gordon Tomaselli

This ongoing study identifies the prevalence of specific anxiety disorders and the clinical and self-reported functional effects of these disorders in a large sample of Implantable Cardioverter Defibrillator (ICD) recipients. To date, 143 recipients of ICDs were evaluated using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID) to establish past and current anxiety disorder diagnoses. These data represent the largest sample of ICD recipients assessed using a structured clinical interview, the gold standard in psychiatric assessment. Self-report questionnaires were also administered to assess anxiety, depression, device-related appraisals, and functional impairment in work, social, and family life. Participants were 73% White, 80% male, 70% married and 27% currently working with a mean age of 64 (±11.5) years. Seventy shocked and 73 non-shocked ICD recipients were interviewed. History of an anxiety disorder was common. The greatest lifetime prevalence rates were for anxiety disorder due to general medical condition (GMC; 30%) and panic disorder (30%). The most common current anxiety disorders were anxiety disorder due to GMC (24%), generalized anxiety disorder (18%) and panic disorder (14%). Shocked participants were more likely to receive lifetime diagnoses of anxiety disorder due to GMC ( t = −2.21, p<.05) and posttraumatic stress disorder ( t = −2.32, p<.05), as well as current diagnoses of panic disorder ( t = −2.23, p<.05) and anxiety due to GMC ( t = −2.42, p<.05). Shocked participants also reported greater worry related to thoughts of receiving a shock ( t = −4.17, p<.01) and were more likely to report disability and impairment in their work ( t = −3.02, p<.01), social ( t = −3.38, p<.001), and family life ( t = −2.72, p<.01) in comparison to their non-shocked counterparts. No significant differences were found in self-reported symptoms of anxiety or depression between shocked and non-shocked participants. Findings characterize the extent, nature, and impact of clinical levels of anxiety among ICD recipients, including differences among shocked versus non-shocked individuals. Clinical applications and the development of appropriately tailored interventions will be discussed.





2001 ◽  
Vol 16 (8) ◽  
pp. 497-500 ◽  
Author(s):  
R. Shiloh ◽  
A. Weizman ◽  
P. Dorfman-Etrog ◽  
N. Weizer ◽  
H. Munitz

SummaryA case is presented in which severe urinary retention (UR) occurred during an acute psychotic exacerbation of paranoid schizophrenia. The voiding dysfunction was apparent during continuous treatment with unchanged doses of haloperidol, and it completely resolved with the remission of the psychotic symptoms. A clear temporal correlation was evident between the patient’s mental status, the Brief Psychiatric Rating Scale (BPRS) score and the degree of the UR as assessed by quantitatively measuring the total daily postvoiding urine residues. We could not relate the UR to any apparent general medical condition or to the haloperidol treatment. The presented data suggests that UR in schizophrenic patients might be the end-result of various psychosis-related mechanisms.







Author(s):  
William S. Breitbart

Anxiety is common in palliative care patients and may significantly impact patients’ quality of life. Anxiety can have many etiologies resulting in different anxiety syndromes, ranging from adjustment disorder, anxiety resulting from general medical condition, to medication-induced anxiety disorders. Pre-existing anxiety disorders should also be taken into consideration in palliative care settings. Different screening and assessment tools have been used to improve recognition and assessment of anxiety in the terminally ill. Treatment of anxiety in this patient population includes use of a variety of pharmacological agents to relieve severe anxiety symptoms and use of psychotherapy interventions that have been shown to be safe and effective in the terminally ill. This chapter includes an overview of the prevalence, assessment, and management of anxiety disorders in palliative care settings.



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