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Anxiety Disorder, Generalized

Differential Diagnoses

Adjustment disorder
Adjustment disorder with anxious features
Adult respiratory distress syndrome
AIDS
Anxiety disorder due to a general medical condition
Cardiac conditions
Cognitive impairment disorders
Hypochondriasis
Major depression
Nonpathological anxiety
Obsessive-compulsive disorder
Panic disorder
Phobia
Post-traumatic stress disorder
Social phobia
Somatization disorder
Substance-induced anxiety disorder
Thyrotoxicosis

Specialists

Clinical Psychologist
Internal Medicine Physician
Psychiatrist

Comorbid Conditions

Alcohol/substance abuse
Cardiovascular conditions
Irritable bowel syndrome
Major depressive disorder
Psychiatric illnesses
Sleep disorders

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The severity of the symptoms, response to treatment, coexistence of substance abuse (especially alcohol dependence), other psychological disorders, underlying medical condition(s), ego strength of the individual, and the individual's social support system can affect the length of disability.

Duration Trends from Reference Data

DURATION TRENDS

ICD-9-CM: 300.02

Cases	Mean	Min	Max	No Lost Time	Over 6 Months
2786	50	0	216	1.5%	1.3%

Percentile:	5^th	25^th	Median	75^th	95^th
Days:	6	18	36	69	147

Differences may exist between the duration tables and the reference graphs. Duration tables provide expected recovery periods based on the type of work performed by the individual. The reference graphs reflect the actual experience of many individuals across the spectrum of physical conditions, in a variety of industries, and with varying levels of case management. Selected graphs combine multiple codes based on similar means and medians.

Medical Codes

	ICD-9-CM:
	300.00 -	Anxiety State, Unspecified; Neurosis, Reaction, State (Neurotic), Atypical Anxiety Disorder
	300.02 -	Generalized Anxiety Disorder

Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

Was diagnosis confirmed?
Does individual fit the criteria of at least 6 months of chronic exaggerated worry that is unfounded or much more severe than the normal anxiety most individuals experience?
Have other psychological disorders been excluded (generalized anxiety disorder symptoms must not be part of another mental disorder)?
Were direct physiological effects of a substance, medication, or a general medical condition ruled out as the cause of the generalized anxiety symptoms?
Were symptoms severe enough to cause significant distress or impairment in social, occupational, educational, or other important areas of functioning?
Was functional impairment evident to others or self-reported by individual?

Regarding treatment:

Has drug therapy been effective in relieving anxiety symptoms?
What other medication options may now be appropriate?
Is individual taking medication properly?
As treatment nears its end and physician gradually tapers the dosage, is individual able to understand directions and comply with a graduated dose schedule? If not, is another available individual who can supervise the medication regimen?
Is individual currently involved in a cognitive-behavioral type therapy that teaches individual to react differently to situations and physical sensations that trigger panic attacks or other anxiety symptoms? If not, would addition of this type of therapy be appropriate in the overall treatment plan?
Would individual benefit from involvement in a therapy group that discusses progress, offers encouragement, and receives guidance from a therapist?
What other forms of personal support are available for individual?

Regarding prognosis:

Is an acute life stress interfering with individual's recovery?
What type of coping skills does individual have or need to learn?
Would individual benefit from additional counseling?

Source: Medical Disability Advisor

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