مطالعه و بررسی نگرانی و علائم جسمانی و عملکردی در اختلال اضطراب فراگیر

ObjectiveTo study the phenomenon of worry and functional somatic symptoms in Generalized Anxiety Disorder (GAD).Method40 subjects with the diagnosis of GAD were assessed by using Penn State Worry Questionnaire (PSWQ) and Bradford Somatic Inventory (BSI). Severity of GAD was rated on Generalized Anxiety Disorder -7 (GAD-7) scale.ResultsThe mean total score on PSWQ was 59.62. All patients had somatic symptoms and the minimum number of somatic symptoms noted in a patient was 11 and maximum was 38. Seventy-five percent of the patients had more than 22 somatic symptoms as per BSI. Majority of the patients (90%) scored more than 10 on GAD-7 scale.ConclusionFuture nosological systems should not limit assessment of somatic symptoms to a list of 6 symptoms only in patients with GAD and should try to operationalise the definition of excessive worry by taking into consideration the common types of worries.

Since the introduction of the term Generalized anxiety disorder (GAD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM) III (1980), qualitative and quantitative modifications have been done within the above-mentioned broadly defined symptom clusters in the diagnostic criteria of GAD. In successive editions of DSM, GAD has been redefined ( APA, 1987 and APA, 1994), so as to increase the validity of this diagnosis by increasing the reliability. In this attempt, the definition, duration and the number of symptoms required to diagnose GAD have been changed multiple times. General trend has been that of reduction in total number of somatic symptoms and redefining “excessive worry” in the diagnosis of GAD. This gradual reduction in number of somatic symptoms along with redefinition of anxiety and worry appears as a shift in focus away from somatic to psychic concern in the diagnosis of GAD ( Bridges et al., 1991). Cross cultural variation in the presentation of psychiatric disorders is well known. The research on the symptoms of GAD in South Asian countries is very scant. It is very much interesting and relevant in clinical practice to explore all the functional somatic symptoms and prominent nature of worry in patients with GAD. The purpose of the current study was to study the phenomology of worry and somatic symptoms in patients with GAD.