anxiety
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Introduction
Fear or apprehension of impending danger or disaster accompanied by somatic & cognitive symptoms not accompanied by a clearly identifiable stimulus.
* also see anxiety disorder
Etiology
- fear
- emotional psychosocial stress
- hypoxia
- aspartame at doses < 15% of FDA maximum daily allowance can fuel anxiety[12]
Epidemiology
- leading cause of mental illness worldwide (4% of global population)[13]
- 62% female
Pathology
- mediated by 5HT-2A receptors in the cerebral cortex[2]
Clinical manifestations
(also see anxiety disorder)
Complications
- disease interaction(s) of air pollution with anxiety
- disease interaction(s) of anxiety with preclinical Alzheimer's disease
Differential diagnosis
- agitation
- prodrome for neurodegenerative disease in the elderly
- stroke
- Parkinson's disease
- various dementias[5], including Alzheimer's disease[6]
- other diagnosis consistent with somatic symptoms[5]
Management
- see anxiety disorder
- benzodiazepines can reduce anxiety in palliative care[10]
- high levels of physical activity associated with 26% lower rates of new onset of anxiety disorder or symptoms[9]
- more diagnostic testing does not lower patient anxiety[3]
- non-pharmacologic approaches to anxiety may diminish adverse effects of psychoactive medications* including delirium, longer hospital & ICU stays[11]
* sedatives, antipsychotics, opiates
More general terms
More specific terms
- anxiety disorder
- anxiety during pregnancy
- free-floating anxiety
- procedural anxiety
- separation anxiety
- situational anxiety
- worried well
Additional terms
References
- ↑ Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999
- ↑ 2.0 2.1 Weisstaub NV et al, Cortical 5-HT2A receptor signaling modulates anxiety-like behaviors in mice. Science 2006, 313:536 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16873667
- ↑ 3.0 3.1 Rolfe A and Burton C. Reassurance after diagnostic testing with a low pretest probability of serious disease: Systematic review and meta-analysis. JAMA Intern Med 2013 Feb 25 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23440131 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1656539
Kroenke K. Diagnostic testing and the illusory reassurance of normal results. JAMA Intern Med 2013 Feb 25 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23440265 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1656535 - ↑ Prescriber's Letter 21(1): 2014 Natural Medicines in the Clinical Management of Anxiety Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=300111&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 5.0 5.1 5.2 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
- ↑ 6.0 6.1 Wilson RS, Begeny CT, Boyle PA et al Vulnerability to stress, anxiety, and development of dementia in old age. Am J Geriatr Psychiatry. 2011 Apr;19(4):327-34. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21427641
- ↑ Alramadhan E, Hanna MS, Hanna MS et al Dietary and botanical anxiolytics. Med Sci Monit. 2012 Apr;18(4):RA40-8. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22460105 Free PMC Article
- ↑ Sarris J, McIntyre E, Camfield DA. Plant-based medicines for anxiety disorders, Part 1: a review of preclinical studies. CNS Drugs. 2013 Mar;27(3):207-19. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23436255
Sarris J, McIntyre E, Camfield DA. Plant-based medicines for anxiety disorders, part 2: a review of clinical studies with supporting preclinical evidence. CNS Drugs. 2013 Apr;27(4):301-19. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23653088 - ↑ 9.0 9.1 Schuch FB, Stubbs B, Meyer J et al. Physical activity protects from incident anxiety: A meta-analysis of prospective cohort studies. Depress Anxiety 2019 Jun 17; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31209958 https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22915
- ↑ 10.0 10.1 Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
- ↑ 11.0 11.1 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
- ↑ 12.0 12.1 Brooks M Can a Common Artificial Sweetener Fuel Anxiety? Medscape. Dec 20, 2022 https://www.medscape.com/viewarticle/985861
- ↑ 13.0 13.1 Soreff S Rapid Review Quiz: Anxiety Medscape. Oct 10, 2022 https://reference.medscape.com/viewarticle/981713
- ↑ Herling SF, Greve IE, Vasilevskis EE et al Interventions for preventing intensive care unit delirium in adults. Cochrane Database Syst Rev. 2018 Nov 23;11(11):CD009783. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30484283 PMCID: PMC6373634 Free PMC article. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009783.pub2/full