Options

Body Background:
Body text color:
Links Color:
CONTENT Color:
Color suggestions:
TOP/FOOTER COLOR:
T/F BG Color:
T/F BG opacity:
HEADER/BOTTOM COLOR:
H/B BG Color:
H/B BG opacity:
This panel is build only for demo purposes. It does not work well on IE
expand

Login Pop-up

Monday, September 27, 2021

Research

Unspecified Anxiety Disorder

Unspecified Anxiety Disorder

It is the experience of many patients with anxiety disorders that they have been told that they suffer from anxiety, without the clinician having offered any specific information on their diagnosis. This is particularly the case in emergency room settings, in which the patient may have applied during the course of the first panic attack. The fact that the clinician may have chosen to name the difficulty of the patient as an anxiety problem, without stating an accurate diagnosis is in accordance with clinical practice. In many instances, this is explained by the fact that the primary goal of the intervention was to address a crisis situation and the clinician did not have enough information to safely decide the precise anxiety diagnosis the patient is suffering from (e.g. hospital emergency rooms).

These patients usually understand and accept that they have a difficulty with anxiety but do not necessarily appreciate that they have a clinical problem that requires expert treatment.  In the experience of many patients, anxiety symptoms are present for long periods of time, even years and decades, without the patients ever having had the chance to know what exactly it is they suffer from.

An unspecified anxiety disorder signifies the particular circumstances in which the description was offered to the patient and it is in effect an intermediary step towards a complete diagnostic evaluation. A complete diagnostic evaluation is the sine qua non of a complete and lasting cure of pathological anxiety.

Important notice: If you or the person you care about experience anxiety symptoms and you are uncertain of what the diagnosis is, you are encouraged to seek professional help for properly and safely addressing these concerns.

Substance-induced Anxiety Disorder

Substance-induced Anxiety Disorder

Sometimes the use of specific substances or medications or withdrawal from their use may initiate an anxiety disorder that is etiologically related to physiological effects of the substance. The most well-known substances and medications that can produce anxiety disorders are:

SUBSTANCES

MEDICATIONS

HEAVY METALS AND TOXINS

  1. Alcohol
  2. Caffeine
  3. Cannabis
  4. Phencyclidine
  5. Hallucinogen
  6. Inhalant
  7. Opioid
  8. Sedative, hypnotic or anxiolytic
  9. Amphetamine
  10. Cocaine
  1. Anesthetics
  2. Analgesics
  3. Bronchodilators
  4. Anticholinergics
  5. Insulin
  6. Thyroid preparations
  7. Oral contraceptives
  8. Antihistamines
  9. Antiparkinsonian medications
  10. Corticosteroids
  11. Antihypertensive medications
  12. Cardiovascular medications
  13. Anticonvulsants
  14. Lithium carbonate
  15. Antipsychotic medications
  16. Antidepressant medications
  1. Organophosphate insecticide
  2. Nerve gases
  3. Carbon monoxide
  4. Carbon dioxide 
  5. Gasoline
  6. Paint

It is possible, and indeed it is the experience of most patients with substance-induced anxiety disorder, that they have used or been exposed to the substance or medication many times or for long periods of time without ever having experienced anxiety symptoms, in relation to the use of the substance or medication. Usually, the symptoms of a substance-induced anxiety disorder subside within 1 month after discontinuation of the substance.  However, it is not uncommon to experience the anxiety symptoms after the first month of discontinuation. In cases such as these, the diagnosis may change to another anxiety disorder, depending on the clinical picture of the patient. 

Important notice: You should not reach the decision that you or the person you have in mind, when reading the above clinical description, suffers from a substance-induced anxiety disorder. We encourage you to seek professional advice, if you feel that you or the persons you care about meet one or more of the clinical criteria.

Specific Phobia

Specific Phobia

The principal difficulty of patients diagnosed with specific phobia is that they experience a striking fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). In children, crying, tantrums, freezing, or clinging may express the fear or anxiety.

The diagnosis of specific phobia is considered when the clinical picture of the patient presents the five following characteristics:

  1. The phobic object or situation almost always provokes immediate fear or anxiety.
  2. The phobic object or situation is actively avoided or endured with intense fear or anxiety.
  3. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
  4. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
  5. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Important notice: You should not reach the decision that you or the person you have in mind, when reading the above clinical description, suffers from specific phobia. We encourage you to seek professional advice, if you feel that you or the persons you care about meet one or more of the clinical criteria.

Medically-induced Anxiety Disorder

Medically-induced Anxiety Disorder

Sometimes during the course of a medical illness it is possible to develop an anxiety disorder that is etiologically associated with the medical illness. The most well-known medical illnesses that can produce anxiety disorders are:

  1. hyperthyroidism
  2. pheochromocytoma
  3. hypoglycemia 
  4. hyperadrenocortisolism 
  5. congestive heart failure 
  6. pulmonary embolism 
  7. atrial fibrillation 
  8. chronic obstructive pulmonary disease
  9. asthma 
  10. pneumonia 
  11. vitamin B12 deficiency
  12. porphyria       
  13. neoplasms
  14. vestibular dysfunction
  15. encephalitis
  16. seizure disorders 

The fact that a patient with a medical illness that can produce an anxiety disorder is actually diagnosed with an anxiety disorder, does not mean that the anxiety disorder is necessarily attributable to the medical illness. Many factors must be taken into account before the clinician decides that the anxiety disorder of the patient is etiologically related to the medical illness.

For instance, the patient who is simultaneously diagnosed with a neoplasm and an anxiety disorder does not necessarily suffer from a neoplasm-induced anxiety disorder. More specifically, if the patient often presented in the past a clinical picture that met the criteria for an anxiety disorder before or during a major medical examination, it is accurate to explain the anxiety disorder of the patient to the pathophysiological effects of the neoplasm and to psychological factors that preceded the input of the pathophysiology of the neoplasm. On the contrary, if the patient rarely presented anxiety related symptoms, before the diagnosis of the neoplasm, the anxiety disorder might be safely categorized as a medically-induced anxiety disorder.

The implications of an accurate medically-induced anxiety diagnosis are decisive for the course of treatment of both medical and psychological disorders. For instance, the cancer patient with a positive prognosis who simultaneously suffers from illness anxiety disorder (description available under the somatic type section in this web site)  and not medically-induced anxiety disorder  may be less able to interpret positively his/her treatment of cancer, because of the interference of the illness anxiety disorder psychology.

Important notice (1): You should not reach the decision that you or the person you have in mind, when reading the above clinical description, suffers from a medically-induced anxiety disorder. We encourage you to seek professional advice, if you feel that you or the persons you care about meet one or more of the clinical criteria.

Important notice (2): In cases of a life-threatening medical illness, it is of the outmost importance to accurately diagnose any comorbid anxiety disorder and urgently controlling it, for allowing the patient the possibility of an optimal response to the life-threatening medical illness.

Selective Mutism

Selective Mutism

The principal difficulty of patients diagnosed with selective mutism is that they experience a repetitive inability to speak in specific social situations in which it is expected of them and they expect it of themselves to speak (e. g., at school).  These patients are perfectly able of articulating speech in other situations.          

The diagnosis of selective mutism is considered when the clinical picture of the patient presents the three following characteristics:

  1. The disturbance interferes with educational or occupational achievement or with social communication.
  2. The duration of the disturbance is at least 1 month (not limited to the first month of school).
  3. The failure to speak is not attributable to a lack of knowledge of, or comfort with, the spoken language required in the social situation in which it occurs.

Important notice: You should not reach the decision that you or the person you have in mind, when reading the above clinical description, suffers from selective mutism. We encourage you to seek professional advice, if you feel that you or the persons you care about meet one or more of the clinical criteria.

Scroll to top