Group Work Diagnosis Notes

Generalized Anxiety Disorder in Adults

a) Description of the disorder including characteristics and
diagnostic features, also a mnemonic to help with revision (e.g.,
GAD and Mr FISC).
Generalised Anxiety Disorder (GAD) is characterised by excessive worrying
more
days than not, for at least 6 months.
Excessive worry means it is difficult to

control and out of proportion to the actual likelihood or impact of the anticipated
event or risk. In adults, the worry can be about everyday things such as work,
personal health, health of family members, financial matters and general life
circumstances. Worry may shift from one topic to another. The anxiety and
worry make it hard to carry out day-to-day activities. It is not attributed to
effects of a substance, medical condition or other mental health disorder.
To help physicians screen for GAD, Bohn (2000) developed the mnemonic device
Does Mr. Fisc worry excessively about minor matters?

M=
R=
F=
I=
S=
C=

Mnemonic for GAD

Muscle tension
Restlessness
Fatigue
Irritability
Sleep
Concentration (difficulty
concentrating)

b) Must include DSM 5 classificatory criteria for the disorder

DSM-5 Diagnostic Criteria for GAD
The DSM-5 (2015) criteria for GAD:
A. Excessive anxiety and worry (apprehensive expectation), occurring more days
than not for at least 6 months, about a number of different events or activities.
B. The person finds it difficult to control the worry.
C. The anxiety and worry are associated with 3 (or more) of the 6 symptoms
listed in the mnemonic.
D. The anxiety, worry and physical symptoms cause clinically significant distress
or impairment in social, occupational, or other important areas.
E. It is not attributed to the effects of substance, medical condition or mental
disorder

c) Differential diagnosis information (i.e., key ways to

distinguish it from other conditions)
Anxiety disorders are the most frequently diagnosed family of mental illnesses.
Among them, GAD is the most common. I
t is the chronic, nonspecific, excessive
nature of the worry that distinguishes GAD from other anxiety disorders
and the
sufferer is unable to lift their mood or rationalise their feelings of fear and
anxiety. Often, the anxiety is not related to a specific circumstance, which means
that the feelings recur. These are not as intense as those experienced during a
panic attack, although the prolonged nature of the anxiety makes it very difficult
for the sufferer to relax.
GAD can be distinguished from other conditions such as: Social anxiety disorder, individuals often anticipate anxiety that is focused on
future social situations whereas GAD sufferers anxiety is non specific and
excessive.
Obsessive-compulsive disorder, the obsessions are inappropriate ideas that take
the form of intrusive and unwanted thoughts, urges or images whereas GAD
sufferers the worry is excessive and abnormal.
Posttraumatic stress disorder and adjustment disorders, the anxiety occurs in
response to an identifiable stressor whereas GAD sufferers anxiety is non
specific and chronic.

d) Other information which will add colour to the picture to

help you remember the features
The disorder occurs most often in women, many people report that they felt
anxious and nervous all of their lives. European descendants are more likely to
experience GAD. GAD is associated with significant disability and accounts for
110 million disability days per year in the United States of America. The
recommended psychological treatment for GAD is Cognitive Behavioural
Therapy.
References:Bohn Paul.Mnemotic Screening Device for Generalized Anxiety Disorder.
American Journal of Psychiatry 2000; 157:837.
Diagnostic and Statistical Manual of Mental Disorders, 2015, Fifth Edition,
American Psychiatric Association.
www.cci.health.wa.gov.au
accessed 16/10/15
http://gad.about.com/od/symptoms/fl/DSM-5-Diagnostic-Criteria-for-Gen
eralized-Anxiety-Disorder.htm
accessed 16/10/15