Anxiety Disorder Due to a General Medical Condition

Diagnostic Features

The essential feature of Anxiety Disorder Due to a General Medical Condition is clinically significant anxiety that is judged to be due to the direct physiological effects of a general medical condition. Symptoms can include prominent, generalized anxiety symptoms, Panic Attacks, or obsessions or compulsions (Criterion A). There must be evidence from the history, physical examination, or laboratory findings that the disturbance is the direct physiological consequence of a general medical condition (Criterion B). The disturbance is not better accounted for by another mental disorder, such as Adjustment Disorder With Anxiety, in which the stressor is the general medical condition (Criterion C). The diagnosis is not made if the anxiety symptoms occur only during the course of a delirium (Criterion D). The anxiety symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion E).

In determining whether the anxiety symptoms are due to a general medical condition, the clinician must first establish the presence of a general medical condition. Further, the clinician must establish that the anxiety symptoms are etiologically related to the general medical condition through a physiological mechanism.

A careful and comprehensive assessment of multiple factors is necessary to make this judgment. Although there are no infallible guidelines for determining whether the relationship between the anxiety symptoms and the general medical condition is etiological, several considerations provide some guidance in this area. One consideration is the presence of a temporal association between the onset, exacerbation, or remission of the general medical condition and the anxiety symptoms. A second consideration is the presence of features that are atypical of a primary Anxiety Disorder (e.g., atypical age at onset or course, or absence of family history). Evidence from the literature that suggests that there can be a direct association between the general medical condition in question and the development of anxiety symptoms may provide a useful context in the assessment of a particular situation. In addition, the clinician must also judge that the disturbance is not better accounted for by a primary Anxiety Disorder, a Substance-Induced Anxiety Disorder, or other primary mental disorders (e.g., Adjustment Disorder).

Specifiers

The following specifiers can be used to indicate which symptom presentation predominates in Anxiety Disorder Due to a General Medical Condition:

With Generalized Anxiety. This specifier may be used if excessive anxiety or worry about a number of events or activities predominates in the clinical presentation.

With Panic Attacks. This specifier may be used if Panic Attacks predominate in the clinical presentation.