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Anxiety Disorder: Generalized Anxiety: Differential Diagnoses & Workup

Author: Dennis A Nutter, Jr, MD, Consulting Staff, Department of Psychiatry, Northeast Georgia Medical Center
Coauthor(s): Lene Holm Larsen, PhD, Instructor, Department of Child and Adolescent Psychiatry, Children's Memorial Hospital of Chicago; Carrie Sylvester, MD, MPH, Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School
Contributor Information and Disclosures

Updated: Sep 18, 2006

Differential Diagnoses

Anxiety Disorder: Obsessive-Compulsive Disorder
Mood Disorder: Bipolar Disorder
Anxiety Disorder: Panic Disorder
Mood Disorder: Depression
Anxiety Disorder: Separation Anxiety and School Refusal
Mood Disorder: Dysthymic Disorder
Anxiety Disorder: Social Phobia and Selective Mutism
Obstructive Sleep Apnea Syndrome
Anxiety Disorder: Specific Phobia
Oppositional Defiant Disorder
Anxiety Disorder: Trichotillomania
Peptic Ulcer Disease
Asthma
Personality Disorder: Avoidant Personality
Attention Deficit Hyperactivity Disorder
Somatoform Disorder: Hypochondriasis
Child Abuse & Neglect: Posttraumatic Stress Disorder
Somatoform Disorder: Somatization
Eating Disorder: Anorexia
Thyroiditis
Hyperthyroidism
Hypothyroidism

Other Problems to Be Considered

Substance-induced anxiety disorder, anxiety disorder due to a general medical condition, an adjustment disorder, or psychotic disorder also should be considered.

Distinguishing anxiety from developmentally appropriate fears is important. Throughout childhood and early adolescence, children experience various transitory fears occurring concurrently with their ability to recognize and understand potential dangers in their environment. A progression occurs from immediate, tangible fears (eg, separation from caregiver, strangers) to anticipatory, less tangible fears (eg, bad dreams, getting hurt, school failure). Children are expected to overcome and resolve these fears as part of the developmental process.

Distinguishing anxiety from realistic worry is also imperative. Worry can be thought of as feeling uneasy or concerned about something. It represents an internal representation of a realistic threat. For example, a child with a learning disability may worry about an upcoming examination, or a child with a medical condition may worry about an upcoming surgery. This kind of worry is expected to be specific to a situation, and it is expected to subside once the situation has passed; thus, the temporal requirement for GAD diagnosis (6 mo) is not met.

Workup

Laboratory Studies

  • Consider urine drug screening, thyroid-stimulating hormone level assessment, and less common laboratory tests based on history and physical findings.

More on Anxiety Disorder: Generalized Anxiety

Overview: Anxiety Disorder: Generalized Anxiety
Differential Diagnoses & Workup: Anxiety Disorder: Generalized Anxiety
Treatment & Medication: Anxiety Disorder: Generalized Anxiety
Follow-up: Anxiety Disorder: Generalized Anxiety
References
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References

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Further Reading

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Keywords

anxiety disorder, generalized anxiety, overanxious disorder, overanxious reaction, generalized anxiety disorder of childhood, generalized anxiety disorder, GAD

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Contributor Information and Disclosures

Author

Dennis A Nutter, Jr, MD, Consulting Staff, Department of Psychiatry, Northeast Georgia Medical Center
Dennis A Nutter, Jr, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry and American Psychiatric Association
Disclosure: Nothing to disclose.

Coauthor(s)

Lene Holm Larsen, PhD, Instructor, Department of Child and Adolescent Psychiatry, Children's Memorial Hospital of Chicago
Disclosure: Nothing to disclose.

Carrie Sylvester, MD, MPH, Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry
Disclosure: Nothing to disclose.

Medical Editor

Chet Johnson, MD, Medical Director, Child Development Unit, Department of Pediatrics, Professor, University of Kansas Medical Center
Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

CME Editor

Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine
Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine
Disclosure: Baxter Honoraria Consulting; Pfizer Honoraria Consulting

Chief Editor

Caroly Pataki, MD, Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Director of Training, Child and Adolescent Psychiatry Residency Program, University of Southern California Keck School of Medicine
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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