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Pediatric Generalized Anxiety Disorder Differential Diagnoses

  • Author: Dennis A Nutter, Jr, MD; Chief Editor: Caroly Pataki, MD  more...
 
Updated: Nov 14, 2014
 
 

Diagnostic Considerations

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 a feeling of unease or concern 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 generalized anxiety disorder (GAD) diagnosis (6 mo) is not met. Of course, persistent and changing realistic worries should be treated if these worries result in significant functional impairment.

Conditions to consider in the differential diagnosis of GAD, in addit

Conditions to consider in the differential diagnosis of GAD, in addition to those in the next section, include the following:

  • Oppositional defiant disorder
  • Peptic ulcer disease
  • Avoidant personality
  • Hypochondriasis
  • Social phobia and selective mutism
  • Specific phobia
  • Trichotillomania
  • Asthma
  • Depression
  • Dysthymic disorder
  • Obstructive sleep apnea syndrome
  • Somatization
  • Panic disorder
  • Substance abuse, including caffeine and tobacco

Go to Pediatric Obsessive-Compulsive Disorder, Pediatric Panic Disorder, and Anxiety Disorders for complete information on these topics.

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Dennis A Nutter, Jr, MD President and Director, North Georgia Neuropsychiatry, PC

Dennis A Nutter, Jr, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Psychiatric Association

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen 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, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Acknowledgements

Chet Johnson, MD Professor and Chair of Pediatrics, Associate Director, Developmental Pediatrician, Center for Child Health and Development, Shiefelbusch Institute for Life Span Studies, University of Kansas School of Medicine; LEND Director, University of Kansas Medical Center

Chet Johnson is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

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 Senior Child and Adolescent Psychiatrist, Sound Mental Health

Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

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