Generalized anxiety disorder risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Irfan Dotani

Overview

Risk factors for developing generalized anxiety disorder include a positive family history, early adulthood, and a recent life stressor. Genetics along with substance-induced anxiety are large factors as well.

Risk Factors

Risk factors for generalized anxiety disorder include:[1]

Genetics

  • Genes are attributed to about 33% of general anxiety disorder's variance.[2]
  • Individuals with a genetic predisposition for GAD are more likely to develop GAD.
    • Especially in response to a life stressor.[3]

Substance-Induced

  • Anxiety can be worsened through the use of benzodiazepines.[4]
    • Benzodiazepines can lead to a lessening of anxiety symptoms.
  • Similarly, long-term alcohol use is associated with anxiety disorders
    • Prolonged abstinence can result in a disappearance of anxiety symptoms.
  • It can take up to two years for anxiety symptoms to return to baseline in about a quarter of people recovering from alcoholism.
  • Tobacco smoking has been established as a risk factor for developing anxiety disorders.[5]
  • Excessive caffeine use has been linked to anxiety.

Case Studies

  • In 1988–90, illness in approximately half of the patients attending mental health services at British hospital psychiatric clinic, for conditions including anxiety disorders such as panic disorder or social phobia, was determined to be the result of alcohol or benzodiazepine dependence.[6]
    • In these patients, anxiety symptoms, while worsening initially during the withdrawal phase, disappeared with abstinence from benzodiazepines or alcohol.
  • Sometimes anxiety, pre-existed alcohol, or benzodiazepine dependence, keep anxiety disorders going and often progressively making them worse.
    • Recovery from benzodiazepines tends to take a lot longer than recovery from alcohol, but people can regain their previous good health.[7]

References

  1. Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
  2. Hettema JM, Neale MC, Kendler KS (2001). "A review and meta-analysis of the genetic epidemiology of anxiety disorders". Am J Psychiatry. 158 (10): 1568–78. doi:10.1176/appi.ajp.158.10.1568. PMID 11578982. Review in: Evid Based Ment Health. 2002 Aug;5(3):92
  3. Donner J, Pirkola S, Silander K, Kananen L, Terwilliger JD, Lönnqvist J; et al. (2008). "An association analysis of murine anxiety genes in humans implicates novel candidate genes for anxiety disorders". Biol Psychiatry. 64 (8): 672–80. doi:10.1016/j.biopsych.2008.06.002. PMC 2682432. PMID 18639233.
  4. Cohen SI (1995). "Alcohol and benzodiazepines generate anxiety, panic and phobias". J R Soc Med. 88 (2): 73–7. PMC 1295099. PMID 7769598.
  5. Morissette SB, Tull MT, Gulliver SB, Kamholz BW, Zimering RT (2007). "Anxiety, anxiety disorders, tobacco use, and nicotine: a critical review of interrelationships". Psychol Bull. 133 (2): 245–72. doi:10.1037/0033-2909.133.2.245. PMID 17338599.
  6. Ashton H (2005). "The diagnosis and management of benzodiazepine dependence". Curr Opin Psychiatry. 18 (3): 249–55. doi:10.1097/01.yco.0000165594.60434.84. PMID 16639148.
  7. Bruce MS, Lader M (1989). "Caffeine abstention in the management of anxiety disorders". Psychol Med. 19 (1): 211–4. PMID 2727208.

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