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Article Title:
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Anxiety -- Is It a Problem for You? 7 questions provide the answer

Article Description:
====================

Generalized Anxiety Disorder (GAD) is "one of the most common 
anxiety problems seen in general medical practices."  Physicians
 are likely to see between 2.8% and 8.5% of their patients 
suffering from this type of anxiety, according to a national 
survey (1).


Additional Article Information:
===============================

869 Words; formatted to 65 Characters per Line
Distribution Date and Time: 2006-07-19 10:48:00

Written By:     Steve B. Reed
Copyright:      2006
Contact Email:  mailto:[EMAIL PROTECTED]


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Anxiety -- Is It a Problem for You? 7 questions provide the answer
Copyright © 2006 Steve B. Reed
Psychotherapy Center
http://www.psychotherapy-center.com



Generalized Anxiety Disorder (GAD) is "one of the most common 
anxiety problems seen in general medical practices."  Physicians 
are likely to see between 2.8% and 8.5% of their patients 
suffering from this type of anxiety, according to a national 
survey (1).

Fortunately, this is just the type of problem that many of the 
new advances in psychotherapy (such as the REMAP process, EFT and 
EMDR) are excellent at treating.  Yet too often, anxiety related 
issues are neither diagnosed nor treated.  What's been missing, 
until now, is a simple and easily available way to spot the 
symptoms and level of intensity that warrants a referral for 
treatment.

The solution to this problem now appears to be at hand.  Robert 
L. Spitzer, MD (and colleagues) report on their development of a 
new, quick and effective tool to measure anxiety in the May 22, 
2006 edition of the Archives of Internal Medicine (2).  The 
anxiety inventory is called the GAD-7 (the Generalized Anxiety 
Disorder-7 questions).

The researchers conclude that the "GAD-7 is a valid and efficient 
tool" to screen for anxiety and to assess "its severity in 
clinical practice and research."   What's most impressive is that 
you can do this by answering seven short questions.  All the 
patient needs to do is read the seven questions and pick one of 
four possible answers.  Each question has a number value (0-3). 
Add the numbers and you quickly arrive at a score between 0 and 
21.

The researchers find that a score of 10 or higher means that a 
significant level of anxiety is present.  Scores over 15 are 
considered severe.  In the study they find that people diagnosed 
with GAD have an average score of 14.4 while people without GAD 
average only 4.9.

Their study also points out the effect on people's lives when 
they suffer from this level of anxiety.

During a three month period, 47% of the people who scored in the 
highest anxiety category suffered difficulties as a result of 
their symptoms.  They also had twice the number of physician 
visits and took over four times the number of sick days from 
work.  The complete details from that portion of the study are 
listed below.

Group averages during 3 months:

anxiety score - disability days - physician visits - % of symptom 
   related difficulty

   0-4          3.9               1.2               15.0
   5-9          7.9               1.7               5.5
   10-14        10.7              2.2               13.7
   15-21        16.8              2.4               47.4

   Percent of symptom related difficulty refers to the response 
   to one additional question-- "How difficult have these 
   problems made it for you to do your work, take care of 
   things at home or get along with other people?" (Not at 
   all; Somewhat difficult; Very difficult or Extremely 
   difficult)


Notably, 96% of patients in the study with GAD-7 scores of 10 or 
greater have been experiencing symptoms for a month or more. 
And, 67% have been suffering from symptoms for 6 months or 
longer.  This suggests that many people are not being diagnosed 
or getting treatment.  This tool may help physicians to make 
appropriate referrals for mental health care and help 
psychotherapists to be alert to the need to focus treatment on 
this issue.

A number of patients with symptoms of high anxiety (according to 
the GAD-7) score low on depression symptoms.  This suggests that 
the dimensions of anxiety and depression need to be assessed 
separately because they do not always coexist.

The authors also point-out that as the symptoms of anxiety 
increase in severity, patients have correspondingly greater 
"impairment in multiple domains of functioning".  The authors 
believe that the GAD-7 can help identify patients with "disabling 
anxiety" that will benefit from treatment.

The GAD-7 (developed by Dr. Robert L. Spitzer, Dr. K. Kroenke, 
and colleagues2) provides a reliable brief scale to identify 
Generalized Anxiety Disorder and to measure the severity of its 
symptoms.  It can help psychotherapists, physicians and even 
potential patients to know if further assessment and possible 
treatment is needed.

By now you are probably wondering, "What are these 7 revealing 
questions?"  Okay, let's look at them and see how you score.

Read each question and think about how often you have felt 
bothered by these symptoms during the past two weeks.  There are 
four possible choices: 0 = not at all, 1 = several days, 2 = more 
than half the days, and 3 = nearly everyday.  Write down the 
number that corresponds to the best answer for each.

1.  Feeling nervous, anxious, or on edge?

2.  Not being able to stop or control worrying?

3.  Worrying too much about different things?

4.  Trouble relaxing?

5.  Being so restless that it is hard to sit still?

6.  Becoming easily annoyed or irritable?

7.  Feeling afraid as if something awful might happen?

Scoring:  Add the results for each question to get a total score. 
Scores above 10 indicate that you may need to consult a licensed 
mental health care provider for further assessment and possible 
treatment for generalized anxiety disorder.


REFERENCES:

1.  Wittchen HU, Zhao S, Kessler RC, Eaton WW. DSM-III-R 
generalized anxiety disorder in the National Comorbidity Survey. 
Arch Gen Psychiatry. 1994;51:355-364.

2.  Spitzer RL, Kroenke K, Williams JB, Lowe B. A Brief Measure 
for Assessing Generalized Anxiety Disorder: The GAD-7. [Journal 
Article] Arch Intern Med. 2006;166(10):1092-7.





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Steve B. Reed, LPC, LMSW, LMFT is a psychotherapist that 
specializes in treating trauma and anxiety disorders including 
social phobia.  He treats people at his Richardson, Texas 
office (Dallas area) and through phone counseling worldwide.  
You can reach Steve at 972-997-9955 or through his website at:
http://www.psychotherapy-center.com  
copyright 1998-2006, Steve B. Reed


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