Diagnosis Of Generalized Anxiety Disorder Research Articles

Prevalence of the generalized anxiety disorder in Tunisia: A study of 707 primary care outpatients.

This study examined the prevalence and correlates of generalized anxiety disorder (GAD) among primary care outpatients. A multicenter, cross-sectional study was conducted that included 707 primary care outpatients being seen at 20 primary healthcare centers in Tunis and Sfax, Tunisia. The Mini International Neuropsychiatric Interview was used to identify a diagnosis of GAD. The Beck Depression Inventory was used to assess depressive symptom severity, and the Sheehan Disability Scale (SDS) was used to measure functional impairment. The prevalence of GAD was 11%. GAD was positively correlated with female gender (P = .005), family history of psychiatric disorder (P < .001), personal history of suicide attempt (P = .019), and depressive symptoms (P < .001). Based on the SDS, severe to very severe functional limitations were reported at work, in social life, and family life (56.4%, 60.2%, and 73.1%, respectively) among GAD patients. This study indicated a relatively high prevalence of GAD among primary care patients in Tunisia. Risk factors were also determined that may help to identify these patients. This information may help primary care physicians recognize this diagnosis and provide timely referrals to mental health professionals to prevent complications and preserve quality of life.

Prevalence of Generalized Anxiety Disorder in Japan: A General Population Survey.

Generalized anxiety disorder (GAD) is among the most prevalent and highly disabling mental health conditions that negatively impacts patient's quality of life (QOL) and disrupts activities of daily living. However, the recognition of GAD is difficult due to substantial overlap with other mental disorders. The purpose of this study was to estimate the prevalence of GAD, assess QOL of probable GAD patients in Japan, and gain insights on the status of visiting medical institutions as well as their recognition/awareness of the disorder. We conducted a web-based cross-sectional survey of 20,009 participants using a questionnaire with approximately 30 single/multiple choice or open-ended questions in Japanese. Overall prevalence of GAD based on Generalized Anxiety Disorder 7-item (GAD-7) cutoff score of ≥10 and questionnaires developed with reference to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria was 7.6% (n=1530) and 6.0% (n=1197), respectively. The degree of coincidence between GAD diagnosis by DSM-5 criteria and GAD-7 scores was moderate (Cohen's Kappa=0.47, p<0.01). Younger people reported a substantially higher prevalence of GAD compared to older. QOL scores assessed using EuroQol 5 dimensions 5-level and EuroQol Visual Analog Scale were substantially lower in probable GAD patients than those with GAD-7<10. Anxiety/depression and pain/discomfort were the most prevalent issues and depression was the most reported comorbidity for the probable GAD patients. Probable GAD patients "currently visiting medical institutions" for anxiety or other mental issues were 27.6% (422/1530); a majority had seen specialists. Most of the probable GAD patients had never heard of the disease. We found higher prevalence of GAD and lower QOL of probable GAD patients in Japan. There is a need for creating awareness about GAD among the general population and developing clinical guidelines on GAD in Japan so that physicians can educate their patients.

Integrating EEG and Ensemble Learning for Accurate Grading and Quantification of Generalized Anxiety Disorder: A Novel Diagnostic Approach.

Current assessments for generalized anxiety disorder (GAD) are often subjective and do not rely on a standardized measure to evaluate the GAD across its severity levels. The lack of objective and multi-level quantitative diagnostic criteria poses as a significant challenge for individualized treatment strategies. To address this need, this study aims to establish a GAD grading and quantification diagnostic model by integrating an electroencephalogram (EEG) and ensemble learning. In this context, a total of 39 normal subjects and 80 GAD patients were recruited and divided into four groups: normal control, mild GAD, moderate GAD, and severe GAD. Ten minutes resting state EEG data were collected for every subject. Functional connectivity features were extracted from each EEG segment with different time windows. Then, ensemble learning was employed for GAD classification studies and brain mechanism analysis. Hence, the results showed that the Catboost model with a 10 s time window achieved an impressive 98.1% accuracy for four-level classification. Particularly, it was found that those functional connections situated between the frontal and temporal lobes were significantly more abundant than in other regions, with the beta rhythm being the most prominent. The analysis framework and findings of this study provide substantial evidence for the applications of artificial intelligence in the clinical diagnosis of GAD.

Investigating the association between work family conflict (WFC) and generalized anxiety disorder (GAD) in an Australian community-based cohort study.

Difficulties managing work and family demands are common and have been found to be associated with stress and poor mental health. However, very few studies have examined Work Family Conflict (WFC) in connection with diagnosable anxiety disorders (and none with Australian representative data). The current study investigated whether high WFC was significantly associated with a diagnosis of Generalised Anxiety Disorder (GAD) after controlling for a broad range of socio-demographic contextual factors, related psychosocial job, family and individual characteristics, and prior anxiety symptom history. Data was analysed from an Australian population-based community cohort - the Personality and Total Health (PATH) Through Life project. Eligible participants (N = 1159) were employed full-time or part-time, with data collected by both online questionnaire and face-to-face interview. Presence of Generalised Anxiety Disorder (GAD) in the past 12-months was diagnosed by the GAD module in the Composite International Diagnostic Interview (CIDI) (based on DSM-IV criteria) and severe anxiety symptoms were measured using the Patient Health Questionnaire (PHQ) 7-item 'other anxiety' model. The findings consistently showed that those experiencing high WFC had higher odds of a GAD diagnosis (final adjusted model: CIDI: OR: 2.55, CI: 1.38-4.70) as well as clinical levels of anxiety symptoms (PHQ: OR:2.61, CI:1.44,4.72). This was the case after controlling for an extensive range of covariates. This is one of the first studies to show that WFC is associated with greater likelihood of GAD. The challenge of juggling both work and family can have far-reaching impacts - not just increasing distress broadly, but also potentially increasing the likelihood of clinically diagnosable anxiety.

Diagnosis and Treatment of Generalized Anxiety Disorder in Japan: Psychiatric Specialist Survey.

Generalized anxiety disorder (GAD) is a suboptimally managed chronic recurring psychiatric condition with a lifetime prevalence of 2.6% in Japan. We assessed the current status of GAD management in Japan. This was an observational, cross-sectional study conducted through an anonymous web-based survey in Japan from December 12-16, 2022. Psychiatrists and psychosomatic medicine physicians who agreed to participate and saw ≥10 outpatients in the previous month were eligible. Survey questionnaire comprised 37 single/multiple choice, numerical entry, or open-ended questions in Japanese. Among 509 participants (493 psychiatrists and 16 psychosomatic medicine physicians), 96.9% were aware of GAD. On average, 12.4 outpatients and 1.0 inpatient were diagnosed with GAD per physician per month. Of 433 physicians having patients diagnosed with GAD, 46.9% used operational diagnostic tools; among these, DSM-5 diagnostic criteria were used by 81.5% physicians. The majority (54.7%) of participants did not use a self-administered rating scale; depression scales were used more than anxiety scales. Among these 433 physicians, 96.8% used selective serotonin reuptake inhibitors for GAD management, and 79.2% used it as the first choice; of 431 physicians who prescribed drug therapy, 54.3% gave antidepressant monotherapy as first choice. The most frequent symptom in patients diagnosed with GAD was excessive anxiety/worry (96.5%); depression was the most commonly reported comorbidity (84.3%) as per physicians aware of GAD (N=508). This study illustrates that although GAD awareness is high among Japanese psychiatric specialists, GAD is not frequently diagnosed using operational diagnostic approaches. Due to a lack of Japanese guidelines for GAD diagnosis and treatment, diverse international guidelines are followed, with similar treatment paradigms as that of depression. This may not be an optimal approach given cultural/geographical differences. These findings highlight the need for uniform diagnosis and treatment recommendations for GAD management in Japan. UMIN-CTR: UMIN000049572.

Exploring the co-occurrence of depression, anxiety and insomnia symptoms, diagnoses and treatments in primary care: observational study using UK primary care data.

Depression, anxiety and insomnia often co-occur. However, there is a lack of research regarding how they cluster and how this is related to medication used to treat them. To describe the frequencies and associations between depression, anxiety and insomnia, and treatment for these conditions in primary care. A retrospective cohort study using UK electronic primary care records. We included individuals aged between 18 and 99 years old with one or more records suggesting they had a diagnosis, symptom or drug treatment for anxiety, depression or insomnia between 2015 and 2017. We report the conditional probabilities of having different combinations of diagnoses, symptoms and treatments recorded. There were 1 325 960 records indicative of depression, anxiety or insomnia, for 739 834 individuals. Depression was the most common condition (n = 106 117 records), and SSRIs were the most commonly prescribed medication (n = 347 751 records). Overall, individuals with a record of anxiety were most likely to have co-occurring symptoms and diagnoses of other mental health conditions. For example, of the individuals with a record of generalised anxiety disorder (GAD), 24% also had a diagnosis of depression. In contrast, only 0.6% of those who had a diagnosis of depression had a diagnosis or symptom of GAD. Prescribing of more than one psychotropic medication within the same year was common. For example, of those who were prescribed an SNRI (serotonin-norepinephrine reuptake inhibitor), 40% were also prescribed an SSRI (selective serotonin reuptake inhibitor). The conditional probabilities of co-occurring anxiety, depression and insomnia symptoms, diagnoses and treatments are high.

Temporal network of experience sampling methodology identifies sleep disturbance as a central symptom in generalized anxiety disorder

BackgroundA temporal network of generalized anxiety disorder (GAD) symptoms could provide valuable understanding of the occurrence and maintenance of GAD. We aim to obtain an exploratory conceptualization of temporal GAD network and identify the central symptom.MethodsA sample of participants (n = 115) with elevated GAD-7 scores (Generalized Anxiety Disorder 7-Item Questionnaire [GAD-7] ≥ 10) participated in an online daily diary study in which they reported their GAD symptoms based on DSM-5 diagnostic criteria (eight symptoms in total) for 50 consecutive days. We used a multilevel VAR model to obtain the temporal network.ResultsIn temporal network, a lot of lagged relationships exist among GAD symptoms and these lagged relationships are all positive. All symptoms have autocorrelations and there are also some interesting feedback loops in temporal network. Sleep disturbance has the highest Out-strength centrality.ConclusionsThis study indicates how GAD symptoms interact with each other and strengthen themselves over time, and particularly highlights the relationships between sleep disturbance and other GAD symptoms. Sleep disturbance may play an important role in the dynamic development and maintenance process of GAD. The present study may develop the knowledge of the theoretical model, diagnosis, prevention and intervention of GAD from a temporal symptoms network perspective.

Is meta-worry relevant to interpersonal problems? Testing the metacognitive model of generalized anxiety disorder in an analogue- and a clinical sample of GAD

ABSTRACT Interpersonal problems are common in individuals with generalized anxiety disorder (GAD) and improved interpersonal functioning is an important goal in treatment. In the metacognitive model of worry and generalized anxiety disorder, emotional distress and psychological dysfunction are related to two distinct types of worry. Particular emphasis is put on meta-worry which refers to “worry about worrying” or appraisal of worrying as threatening in itself. Meta-worry impairs effective mental regulation and might therefore be an important predisposition to self-regulate via others and thereof interpersonal problems. In the current study, we tested the prediction that meta-worry is uniquely associated with interpersonal problems in two samples. The first consisted of 135 individuals with analogue GAD and the second of 56 individuals with a diagnosis of GAD. Using hierarchical linear regressions controlling for anxiety, depression and worry, meta-worry showed a unique relationship with interpersonal problems in both samples. These findings indicate that meta-worry may be relevant to formulate and treat interpersonal problems in individuals with GAD.

Transdiagnostic Mood, Anxiety, and Trauma Symptom Factors in Alcohol Use Disorder: Neural Correlates Across 3 Brain Networks

BackgroundAlcohol use disorder (AUD) is associated with high rates of trauma, mood, and anxiety disorders. Across these diagnoses, individual symptoms substantially overlap, highlighting the need for a transdiagnostic approach. Furthermore, there is limited research on how transdiagnostic psychopathology impacts the neural correlates of AUD. Thus, we aimed to identify symptom factors spanning diagnoses and examine how they relate to the neurocircuitry of addiction. MethodsEighty-six veterans with AUD completed self-report measures and reward, incentive salience, and cognitive control functional magnetic resonance imaging tasks. Factor analysis was performed on self-reported trauma, depression, anxiety, and stress symptoms to obtain transdiagnostic symptom compositions. Neural correlates of a priori–defined regions of interest in the 3 networks were assessed. Independent sample t tests were used to compare the same nodes by DSM-5 diagnosis. ResultsFour symptom factors were identified: Trauma distress, Negative affect, Hyperarousal, and Somatic anxiety. Trauma distress score was associated with increased cognitive control activity during response inhibition (dorsal anterior cingulate cortex). Negative affect was related to lower activation in reward regions (right caudate) but higher activation in cognitive control regions during response inhibition (left dorsolateral prefrontal cortex). Hyperarousal was related to lower reward activity during monetary reward anticipation (left caudate, right caudate). Somatic anxiety was not significantly associated with brain activation. No difference in neural activity was found by posttraumatic stress disorder, major depressive disorder, or generalized anxiety disorder diagnosis. ConclusionsThese hypothesis-generating findings offer transdiagnostic symptom factors that are differentially associated with neural function and could guide us toward a brain-based classification of psychiatric dysfunction in AUD. Results warrant further investigation of transdiagnostic approaches in addiction.

Evaluation of an online-based self-help program for patients with generalized anxiety disorder - A randomized controlled trial

ObjectivesThis study aimed to evaluate the effects of an online self-help intervention for generalized anxiety disorder (GAD). Our primary outcomes were generalized anxiety symptoms, measured using the Generalized Anxiety Disorder – 7 (GAD-7; Spitzer et al., 2006), and wellbeing based on the World Health Organization Wellbeing Index - 5 (WHO-5; Topp et al., 2015). MethodsA total of 156 German-speaking patients aged 18 to 65 with a diagnosis of GAD and internet access were included in this randomized controlled trial. The intervention group (N = 78) received access to a 12-week online self-help program, while the waitlist control group (N = 78) received access after the 12-week waiting period. ResultsThe intervention group showed a significant improvement in generalized anxiety symptoms compared to the control group (t(df = 123.73) = 4.52, p < .001) with a large effect size (d = 0.88, 95 %-CI: 0.50; 1.26). Additionally, the intervention group demonstrated a significant increase in wellbeing compared to the control group (t(df = 87,86) = 3.48, p < .001), with a moderate effect size (d = 0.62, 95 % CI: 0.27; 0.98). However, no significant effects were observed for secondary outcomes of functional impairments, work productivity, mental health literacy, and healthcare demands. For exploratory outcomes, improvement was found for anxiety and worry symptoms. ConclusionsThese findings suggest that an online-based self-help intervention effectively reduces GAD symptoms and improves overall wellbeing. Future research should explore the long-term effects of this intervention and investigate potential mechanisms underlying its efficacy. Public health implicationsOnline-based self-help programs provide a promising treatment option for individuals with GAD who face barriers to traditional face-to-face therapy.

Prevalence and factors associated with generalized anxiety disorder among patients with chronic pain: A single center cross sectional study in Malaysia.

Managing chronic pain was not only a major challenge but also a source of significant disability associated with mental illness. Studies on generalized anxiety disorder (GAD) in chronic pain population was rather limited. This study was aimed to determine the prevalence of GAD and its associated factors among patients attending a pain clinic at a general hospital. This cross-sectional study recruited 201 patients. The Hospital Anxiety Depression Scale (HADS) was used to determine anxiety level. Subsequently, patients who had scored 8 and above on the HADS were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I) to ascertain the diagnosis of GAD. Whilst the Numerical Rating Scale (NRS) assessed pain severity. Multiple logistic regression analysis was used to determine factors associated with GAD. Among those patients with chronic pain, the prevalence of GAD was 18.9%. Gender (AOR:7.94; 95% CI:2.34, 26.93), duration of the pain (AOR:1.30; 95% CI:1.03,1.63) and pain severity (AOR:18.75; CI:1.23,285.13) were significant factors associated with GAD. GAD is a prevalent condition among chronic pain patients.

Generalized anxiety disorder among patients attending primary health care at security forces hospital, in Dammam, Saudi Arabia

Background: Generalized anxiety disorder (GAD) among patients presents an essential and increasing mental health concern for which prevalence data are needed. The aim of the present study was to measure the prevalence of GAD among patients attending primary health care (PHC) and its association with sociodemographic factors and mental disorders. Methods: A cross-sectional study was conducted among adult patients at Security Forces Hospital. An Arabic self-administered questionnaire composed of two parts: sociodemographic data (age, gender, medical history of GAD diagnosis, and psychiatric comorbidities) and the 7-item generalized anxiety disorder (GAD-7) scale. Results: A total of 386 individuals participated in our questionnaire, of whom 53.1% were males and the remainder 46.9% were females. According to the GAD-7 questionnaire, the overall prevalence of generalized anxiety disorder (GAD) was 12.7%. However, the prevalence of anxiety severity was as follows: 56.2% had no or minimal anxiety, 31.1% had mild anxiety, 8.8% had moderate anxiety, and 3.9% had severe anxiety. Females had a significantly higher mean GAD score (15.7% times higher) compared to males in general. Patients with a previous diagnosis of GAD or co-occurring mental disorders had a higher mean GAD score compared to patients not known to have mental disorders. Conclusion: The present study found the overall prevalence of GAD to be 12.7%. Further studies are needed in various cities.

Enhancing generalized anxiety disorder diagnosis precision: MSTCNN model utilizing high-frequency EEG signals.

Generalized Anxiety Disorder (GAD) is a prevalent mental disorder on the rise in modern society. It is crucial to achieve precise diagnosis of GAD for improving the treatments and averting exacerbation. Although a growing number of researchers beginning to explore the deep learning algorithms for detecting mental disorders, there is a dearth of reports concerning precise GAD diagnosis. This study proposes a multi-scale spatial-temporal local sequential and global parallel convolutional model, named MSTCNN, which designed to achieve highly accurate GAD diagnosis using high-frequency electroencephalogram (EEG) signals. To this end, 10-min resting EEG data were collected from 45 GAD patients and 36 healthy controls (HC). Various frequency bands were extracted from the EEG data as the inputs of the MSTCNN. The results demonstrate that the proposed MSTCNN, combined with the attention mechanism of Squeeze-and-Excitation Networks, achieves outstanding classification performance for GAD detection, with an accuracy of 99.48% within the 4-30 Hz EEG data, which is competitively related to state-of-art methods in terms of GAD classification. Furthermore, our research unveils an intriguing revelation regarding the pivotal role of high-frequency band in GAD diagnosis. As the frequency band increases, diagnostic accuracy improves. Notably, high-frequency EEG data ranging from 10-30 Hz exhibited an accuracy rate of 99.47%, paralleling the performance of the broader 4-30 Hz band. In summary, these findings move a step forward towards the practical application of automatic diagnosis of GAD and provide basic theory and technical support for the development of future clinical diagnosis system.

A RANDOMIZED CONTROLLED TRIAL OF SELF-HELP GUIDED BY LAY PROVIDERS FOR GENERALIZED ANXIETY DISORDER IN OLDER ADULTS

Abstract Low use of professional help for anxiety disorders in older adults may be due in part to limited access to mental health services. Self-help guided by lay providers (LPs) could help improve access to treatment. This study evaluated the efficacy and long-term outcomes of self-help guided by LPs for generalized anxiety disorder (GAD) in older adults. Participants (≥ 60 years) with threshold or subthreshold GAD were randomly assigned to an intervention group (n = 75) or a wait-list control group (n = 75). Intervention group participants used a manual presenting readings and exercises based on principles of cognitive-behavioral therapy and received weekly support calls by LPs. Groups were similar in terms of sociodemographic characteristics and initially did not differ significantly on outcomes. At post-treatment, the intervention group had decreased significantly on various measures while the wait-list group remained stable: Generalized Anxiety Disorder 7-item (GAD-7): -4.8 vs -.03; Penn State Worry Questionnaire (PSWQ): -11.7 vs .07; Geriatric Anxiety Inventory (GAI): -5.3 vs -.07. Probability of having a diagnosis of threshold GAD decreased significantly more in the intervention group (79% to 16% vs 74% to 53%). Intervention group scores on the GAD-7, the PSWQ, and the GAI as well as probability of having a diagnosis of threshold GAD remained stable at 6- and 12-month follow-ups. Results provide evidence of the efficacy of self-help guided by LPs for GAD in older adults as well as of the maintenance of improvement following this treatment.

P158: Efficacy of a self-help cognitive-behavioral therapy (GSH-CBT) guided by lay providers for generalized anxiety disorder (GAD) in older adults: preliminary results

Background:Only a small proportion of older adults with generalized anxiety disorder (GAD) seek professional help. One reason is the lack of access to mental health professionals licensed to provide psychotherapy. One way to improve access to psychotherapy is through guided self- help (GSH). GSH based on the principles of cognitive-behavior therapy (GSH-CBT) can be guided by trained lay providers (LPs). The purpose of this poster is to report preliminary results from a multisite randomized controlled trial testing the efficacy of a GSH-CBT guided by LPs for GAD in older adults.Methods:The sample included 150 participants (≥ 60 years old) with a diagnosis of threshold or subthreshold GAD randomly assigned to: 1) GSH-CBT guided by LPs (n = 75) or 2) waiting list (n = 75). The GSH-CBT lasted 15 weeks. Participants used a manual presenting weekly reading and at-home exercises. They also received weekly support calls (30 minutes maximum) by LPs (undergraduate psychology students) supervised by psychologists. Repeated-measures regression models were used to compare changes in the groups before and after 15 weeks on three outcomes: severity of GAD symptoms (Generalized Anxiety Disorder 7-item; GAD-7), tendency to worry (Penn State Worry Questionnaire; PSWQ), and level of anxiety (Geriatric Anxiety Inventory; GAI).Results:At the first assessment, both groups were similar in terms of age, sex, level of education, marital status, occupation, and did not differ significantly on outcomes. The GSH- CBT group decreased significantly on all three outcomes (GAD-7: -4.8, 95% CI [-5.7, -3.8], PSWQ: -11.7; 95% CI [-13.6, -9.9], GAI: -5.3 95% CI [-6.5, -4.1]) while the waiting list group remained stable over 15 weeks (GAD-7: -0.3, 95% CI [-1.2, 0.6], PSWQ: 0.7; 95% CI [-1.2, 2.5], GAI: -0.7 95% CI [-1.9, -0.5]).Conclusions:GSH-CBT guided by LPs appears to be an effective intervention for reducing severity of GAD symptoms, tendency to worry, and level of anxiety in older people with GAD. Further analyses will be conducted to test whether the intervention differs in efficacy between participants with a threshold vs. subthreshold GAD. The maintenance of long-term gains (6 and 12 months after the intervention) will also be tested.

PRKCA and TCF4 Genetic Variants in Anxiety Symptoms and Generalized Anxiety Disorder in a Sample of Colombian Subjects Selected on the Basis of High Anxiety Scores

Objective: There are several anxiety disorders leading to a high burden of disease around the world, including Generalized Anxiety Disorder (GAD). The heritability of GAD suggests that genetic factors play an important role in its development; however, further research in this area is needed in Latin America. This study aimed to analyze the possible association between two single nucleotide polymorphisms (SNPs), rs2244497 and rs1452789, located in the PRKCA and TCF4 genes with anxiety symptoms and GAD based on high anxiety scores in a sample of selected Colombian subjects. Methods: We evaluated 303 participants using the Hospital Anxiety and Depression Scale (HADS) and Zung’s Self-Rating Anxiety Scale (ZSAS). Subjects with high scores in both scales (according to established cut-off points) participated in a psychiatric evaluation for the diagnosis of GAD. TaqMan assays were employed to genotype the SNPs, and statistical analyses were performed using logistic and linear regression. Results: In a sample of Colombian subjects selected on the basis of high anxiety scores, we found a significant association between the rs2244497 SNP in the PRKCA gene and higher scores in anxiety symptoms, where people carrying the T/T genotype had the highest scores for HADS scale. However, we did not observe this association in people diagnosed with GAD. In addition, the SNP in TCF4 (rs1452789) did not have an association with anxiety symptoms or GAD diagnosis. Conclusion: This study contributes to the analysis of the molecular basis of anxiety disorders in selected Latin American samples. However, further studies are necessary to understand the role of rs2244497 SNP in the PRKCA gene and the risk for higher scores in anxiety symptoms.

ГЕНЕРАЛИЗОВАННОЕ ТРЕВОЖНОЕ РАССТРОЙСТВО, ЕГО ВЛИЯНИЕ НА СЕРДЕЧНО-СОСУДИСТУЮ СИСТЕМУ И СОВРЕМЕННЫЕ ПОДХОДЫ К ТЕРАПИИ

The aim of the article is to analyze the most modern and effective approach to the treatment of generalized anxiety disorder (GAD). This disorder occurs quite often - up to 6.6% among other neuroses. To prescribe the right therapy, first of all, it is necessary to accurately diagnose it. Since GAD has a rather high comorbidity (combination with other neurotic disorders), diagnosis is often difficult, as a result of which the selection of therapy may be inaccurate. In addition, a number of factors play a role in the etiology of GAD - genetic, social (various stressful moments), as well as somatic predisposition. To date, no preference has been given in its etiology to any specific factor. They may vary from patient to patient. In this connection, in the diagnosis of GAD, a strict individual approach is important in the selection of therapy.

Psychotherapies for Generalized Anxiety Disorder in Adults

Generalized anxiety disorder (GAD) is one of the most common mental disorders in adults. Psychotherapies are among the most recommended treatments for GAD, but which should be considered as first-line treatment needs to be clarified. To use a network meta-analysis to examine the short- and long-term associations of different psychotherapies with outcomes of effectiveness and acceptability in adults with GAD. MEDLINE, Embase, PsycINFO, and the Cochrane Register of Controlled Trials were searched from database inception to January 1, 2023, to identify randomized clinical trials (RCTs) of psychotherapies for adults with GAD. RCTs comparing any type of psychotherapy against another or with a control condition for the treatment of adults (≥18 years, both sexes) with a primary diagnosis of GAD were eligible for inclusion. This study followed Cochrane standards for extracting data and assessing data quality and used the PRISMA guideline for reporting. Risk of bias of individual studies was assessed using the second version of the Cochrane risk of bias tool, and the Confidence in Network Meta-Analysis was used to rate the certainty of evidence for meta-analytical results. Eight psychotherapies were compared against one another and with 2 control conditions. Primary outcomes were severity of GAD symptoms and acceptability of the psychotherapies. Random-effects model pairwise and network meta-analyses were conducted. For effectiveness, standardized mean differences (SMDs) were pooled, and for acceptability, relative risks with 95% CIs were calculated. Data from 65 RCTs were included. Effect size estimates on data from 5048 participants (mean [SD], 70.9% [11.9%] women; mean [SD] age, 42.2 [12.5] years) suggested that third-wave cognitive behavior therapies (CBTs) (SMD, -0.76 [95% CI, -1.15 to -0.36]; certainty, moderate), CBT (SMD, -0.74 [95% CI, -1.09 to -0.38]; certainty, moderate), and relaxation therapy (SMD, -0.59 [95% CI, -1.07 to -0.11]; certainty, low) were associated with reduced GAD symptoms vs treatment as usual. Relative risks for all-cause discontinuation (indication of acceptability) signaled no differences compared with treatment as usual for all psychotherapies (eg, relative risk, 1.04 [95% CI, 0.64-1.67] for CBT vs treatment as usual). When excluding studies at high risk of bias, relaxation therapy lost its superiority over treatment as usual (SMD, -0.47; 95% CI, -1.18 to 0.23). When considering anxiety severity at 3 to 12 months after completion of the intervention, only CBT remained significantly associated with greater effectiveness than treatment as usual (SMD, -0.60; 95% CI, -0.99 to -0.21). Given the evidence in this systematic review and network meta-analysis for its associations with both acute and long-term effectiveness, CBT may represent the first-line therapy of GAD. Third-wave CBTs and relaxation therapy were associated with short-term effectiveness and may also be offered.

A Comprehensive Review of the Generalized Anxiety Disorder.

Excessive, uncontrollable, and usually unjustified worry about certain things is a sign of the mental and behavioral disease known as generalized anxiety disorder (GAD). Genetic research suggests that numerous genes are likely implicated in the development of GAD, even if much is yet unclear about this. As a result, if someone in a family has GAD, there is a high likelihood that someone else will also suffer from the illness, as well as another anxiety disorder. Individuals with GAD are frequently overly bothered about workaday affairs like health, assets, demise, family, accord issues, or effort challenges. Worry frequently interferes with daily functioning. Excessive concern, restlessness, difficulty sleeping, tiredness, irritability, sweating, and trembling are a few symptoms that may be present. For a formal diagnosis of GAD, symptoms must be persistent for at least six months and consistent. Conversion in the amygdala's utilitarian congruence and how it processes fear and anxiety have been linked to generalized anxiety disorder. Neurotransmitters, and particularly the gamma-aminobutyricacid (GABA) variant, have long been known to cause GAD through dysregulating amygdala activity in the brain. Anxiety, concern, or physical symptoms must significantly hinder social, academic, or occupational functioning in order to qualify for a GAD diagnosis. The Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) provides explicit ethos to aid doctors in identifying this disorder. Psychological therapy based on cognitive behavioral therapy (CBT) principles is effective in reducing anxiety symptoms for short-term treatment of GAD. In this, the patient's thinking ability and methods are focused. The main principle behind CBT is that your thought patterns affect your feelings, which in turn can affect your behavior. Drugs like antidepressants, buspirone, benzodiazepines, and can all be worn to goody GAD. Outside of therapy, patients with anxiety can learn to manage it by practicing relaxation methods, reframing unfavorable ideas, and adopting stress-relieving adjustments. Being socially active and setting aside time for proper self-care are crucial components of managing generalized anxiety disorder.

Comparing the Efficacy of an Electronically Delivered Cognitive Behavioral Therapy Program to a Mental Health Check-In Program for Generalized Anxiety Disorder: Protocol for a Randomized Trial.

Generalized anxiety disorder (GAD) is a prevalent anxiety disorder, with cognitive behavioral therapy (CBT) being the gold standard treatment. However, it is inaccessible and costly to many, as the mental health industry is overwhelmed by the demand for treatment. This means effective, accessible, and time-saving strategies must be developed to combat these problems. Web-based interventions for mental health disorders are an innovative and promising way to address these barriers. While electronically delivered CBT (e-CBT) has already proved productive and scalable for treating anxiety, other less resource-intensive interventions can be innovated. Checking up on mental health face-to-face has been shown to provide similar benefits to patients with anxiety disorders previously, but more research is needed to evaluate the efficacy of web-based delivery of this intervention. This study will compare the efficacy of e-CBT and a web-based mental health check-in program to treat GAD. These programs will both be delivered through a secure, web-based care delivery platform. We will randomly allocate participants (N=100) who are 18 years or older with a confirmed diagnosis of GAD to either an e-CBT program or a mental health check-in program over 12 weeks to address their anxiety symptoms. Participants in the e-CBT arm will complete predesigned modules and homework assignments while receiving personalized feedback and asynchronous interaction with a therapist through the platform. Participants in the mental health check-in arm will be contacted weekly through the web-based platform's written chat feature (messaging system). Therapists will ask the participants a series of predesigned questions that revolve around a different theme each week to prompt conversation. Using clinically validated questionnaires, the efficacy of the e-CBT arm will be compared to the mental health check-in arm. These questionnaires will be completed at baseline, week 6, and week 12. The study received ethics approval in April 2021, and participant recruitment began in May 2021. Participant recruitment has been conducted through targeted advertisements and physician referrals. Complete data collection and analysis are expected to conclude by August 2023. Linear and binomial regression (continuous and categorical outcomes, respectively) will be conducted. To the research team's knowledge, this will be the first study to date comparing the efficacy of e-CBT with a web-based mental health check-in program to treat GAD. The findings from this study can help progress the development of more scalable, accessible, and efficacious mental health treatments. ClinicalTrials.gov NCT04754438; https://classic.clinicaltrials.gov/ct2/show/NCT04754438. DERR1-10.2196/48899.