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- W2024264511 abstract "Before the initial introduction of generalized anxiety disorder (GAD) in the DSM-III, patients with severe and chronic anxiety were given the diagnosis of anxiety neurosis, a term introduced by Freud more than 100 years ago. In the DSM-III, the subcategory of “anxiety neurosis” became “anxiety states” that included panic disorder, GAD, and obsessive-compulsive disorder; however, DSM-III–defined GAD represented a residual diagnosis that could not be assigned if patients met criteria for another mental disorder. That residual status of GAD was dropped in the DSM-III-R, allowing an independent diagnosis of GAD in addition to other mental disorders. The American Psychiatric Association also revised the diagnostic criteria for GAD, requiring the presence of unrealistic, excessive anxiety and worry for at least 6 months as manifested by at least 6 symptoms from a list of 18 somatic symptoms, which formed three clusters of motor tension, autonomic hyperactivity, vigilance, and scanning. In 1994, the DSM-IV Anxiety Task Force made further revisions to those earlier DSM-III-R diagnostic criteria for GAD. Some of the more substantial revisions made in the DSM-IV included increased emphasis on uncontrollable worry and less emphasis on autonomic symptoms, requiring only six physical symptom criteria (e.g., restlessness or feeling “keyed up” or “on edge,” being easily fatigued, difficulty concentrating or mind “going blank,” irritability, muscle tension, and sleep disturbance). This reduction was accomplished by empiric studies of GAD patients that resulted in the elimination of symptoms constituting the autonomic hyperactivity cluster that were found to be only infrequently endorsed by patients with GAD.6, 42 Although, in the past, the validity of GAD as an independent diagnostic category was questioned, increasing data indicate that GAD is a common, severe, and distinct illness that leads to significant morbidity.9, 43, 51, 63, 87 Also, GAD seems to carry a significant “price tag” to the affected individual and to society.82 Unfortunately, in contrast to other anxiety disorders, relatively less attention has been devoted to the investigation of the biological correlates and, subsequently, the pharmacologic treatments for GAD. The shifting diagnostic criteria, the concerns about low diagnostic reliability in many studies, and questions regarding its validity may have contributed to the limited research of GAD. Thus, certain issues, such as comparative efficacy of pharmacotherapies in the treatment of patients with GAD, long-term treatment, and medication discontinuation, remained largely unexplored. This article reviews the available data on the pharmacologic treatment of patients with GAD, with additional emphasis on treatment of comorbid conditions, and treatment resistance." @default.
- W2024264511 created "2016-06-24" @default.
- W2024264511 creator A5090144152 @default.
- W2024264511 date "2001-03-01" @default.
- W2024264511 modified "2023-10-18" @default.
- W2024264511 title "Pharmacologic Treatment of Generalized Anxiety Disorder" @default.
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- W2024264511 doi "https://doi.org/10.1016/s0193-953x(05)70209-4" @default.
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