Anxiety Disorders: Guidelines for Effective Primary Care, Part 1, Diagnosis

The initial assessment of a patient who presents with anxiety symptoms in a primary care setting usually focuses on ruling out medical causes, especially the numerous drugs-such as stimulants, sympathomimetics, antihypertensives, and NSAIDs-that can cause anxiety. The selection of initial laboratory tests depends on the presence of abnormal physical findings; imaging studies would be indicated whenever specific medical disorders need to be exduded. Also assess the patient for other psychiatric disorders that may be associated with anxiety symptoms; these include adjustment disorders, mood disorders (depression or bipolar disorder), alcohol and other substance abuse disorders, and depressive symptoms, which often coexist with anxiety symptoms. The primary anxiety disorders most commonly seen in the primary care setting include generalized anxiety disorder, agoraphobia, panic disorder, specific phobias, social phobia (social anxiety disorder), obsessive-compulsive disorder, acute stress disorder, and post-traumatic stress disorder.