The Psychiatric clinics of North America
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Psychiatr. Clin. North Am. · Mar 1985
Review Case ReportsThe differential diagnosis of anxiety. Psychiatric and medical disorders.
This article has reviewed clinical and demographic features of the primary anxiety disorders and other psychiatric and medical disorders that often are associated with anxiety symptoms, highlighting differential diagnosis. In summary, phobic disorders (exogenous anxiety) are characterized by anxiety reliably elicited by specific environmental stimuli; the stimuli involved determine which type of phobia is diagnosed. In contrast, panic attacks and generalized anxiety (endogenous anxiety) involve symptoms of anxiety not associated only with specific eliciting stimuli. ⋯ Attention to the clinical and demographic features listed in Table 4, as well as the use of newly-developed structured diagnostic interviews should usually lead to a correct diagnosis, as illustrated by the following examples. The onset of a fear of public speaking in mid-adolescence suggests an uncomplicated social phobia, whereas the onset in the mid-twenties of several social and other situational anxieties in a person with a previous history of panic attacks would be strongly suggestive of the panic-agoraphobia syndrome. The new onset of generalized anxiety symptoms and depression in a 45-year-old patient who has had a previous significant depression would suggest that this person's anxiety is part of, and secondary to, the affective disorder and not a primary anxiety disorder.(ABSTRACT TRUNCATED AT 400 WORDS)