Anxiety Disorders Differential Diagnoses

Updated: Mar 27, 2019
  • Author: Nita V Bhatt, FAPA, MD, MPH; Chief Editor: David Bienenfeld, MD  more...
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DDx

Diagnostic Considerations

Prior to medication treatment, order testing for drugs of abuse, pregnancy, and screening tests for diabetes mellitus.

Anxiety disorders have one of the longest differential diagnosis lists of all psychiatric disorders. Anxiety is a nonspecific syndrome and can be due to a variety of medical or psychiatric syndromes. For example, a 2018 study found that about 30% of those with anxiety also have autoimmune thyroiditis (AIT). [40]  Additionally, a variety of anxiety symptoms, such as panic, worry, rumination, and obsessions, can present in a variety of psychiatric illnesses, including mood disorders, psychotic disorders, personality disorders, somatoform disorders, and cognitive impairment disorders (eg, delirium). Anxiety also can be observed as part of a drug withdrawal or drug intoxication effect.

Other important causes in the differential include medication-induced anxiety (ie, due to epinephrine or other sympathomimetics, theophylline or other neurostimulant bronchodilators, analgesics containing caffeine, corticosteroids, antivirals, others); migraine, seizure disorders, or other CNS-based disorders; and sleep disorders such as restless legs syndrome, sleep apnea, and periodic limb movement. Heroin abuse also should be considered in the differentials.

Differential Diagnoses