A 27-year-old electrician is describing symptoms that do not meet the full criteria for any of the disorders in the anxiety disorders diagnostic class of the Diagnostic Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013); therefore, a diagnosis of other specified anxiety disorder is appropriate. However, it should be noted that the symptoms described are highly characteristic of generalized anxiety disorder (GAD) and meet 5 out of the 6 criteria for GAD. More information or further development is needed to determine if the client has GAD. For one, the client claims that he has many worries—e.g., worries that involve the health of his parents and his social approval level at work. The cardinal
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Moreover, he claims that he has experienced dizziness, sweaty palms, heart palpitations, and ringing in the ears for more than 18 months. Most of these associated symptoms and features are characteristic of individuals that have GAD, but only two of the associated symptoms that he has experienced most days over 2 years—the persistent “edgy” feeling and extreme muscle tension—are included in the third criterion. Because he is only experiencing two symptoms in the third criterion, which requires the expression of three or more specific symptoms for most days over the past 6 months, he does not meet the third criterion. To fully meet the third criterion, the client would have to experience at least one more associated symptom such as fatigue, difficulty concentrating, irritability, or sleep disturbance for most days over the past 6 months. It is possible that he experiences such symptoms, but the available data do support such an assumption presently. Of course, the client has noted that he experiences other associated symptoms and features of GAD that were mentioned previously. Indeed, the client did note other somatic symptoms (e.g., sweaty hands) and symptoms of autonomic hyperarousal (e.g., dizziness), which are associated features that …show more content…
Of course, a diagnosis of GAD is another likely diagnosis that may be given in this case. This diagnosis may be given if a clinician were to assume, based on the available data, that the client was experiencing additional symptoms (e.g., irritability) that would allow the client to meet the third criterion and thus the full criteria for GAD. In the case of this diagnosis, such an assumption has not been made. The available data, however, do speak strongly to such a diagnosis: the client is experiencing excessive worry and anxiety that is uncontrollable, as well as a multitude of associated symptoms and features and associated impairment in two domains. If data were to come to light that reveal relevant missing symptoms, or if some time were to pass and the client began to note the new experience of relevant missing symptoms, then the diagnosis of GAD would be
Moreover, he claims that he has experienced dizziness, sweaty palms, heart palpitations, and ringing in the ears for more than 18 months. Most of these associated symptoms and features are characteristic of individuals that have GAD, but only two of the associated symptoms that he has experienced most days over 2 years—the persistent “edgy” feeling and extreme muscle tension—are included in the third criterion. Because he is only experiencing two symptoms in the third criterion, which requires the expression of three or more specific symptoms for most days over the past 6 months, he does not meet the third criterion. To fully meet the third criterion, the client would have to experience at least one more associated symptom such as fatigue, difficulty concentrating, irritability, or sleep disturbance for most days over the past 6 months. It is possible that he experiences such symptoms, but the available data do support such an assumption presently. Of course, the client has noted that he experiences other associated symptoms and features of GAD that were mentioned previously. Indeed, the client did note other somatic symptoms (e.g., sweaty hands) and symptoms of autonomic hyperarousal (e.g., dizziness), which are associated features that …show more content…
Of course, a diagnosis of GAD is another likely diagnosis that may be given in this case. This diagnosis may be given if a clinician were to assume, based on the available data, that the client was experiencing additional symptoms (e.g., irritability) that would allow the client to meet the third criterion and thus the full criteria for GAD. In the case of this diagnosis, such an assumption has not been made. The available data, however, do speak strongly to such a diagnosis: the client is experiencing excessive worry and anxiety that is uncontrollable, as well as a multitude of associated symptoms and features and associated impairment in two domains. If data were to come to light that reveal relevant missing symptoms, or if some time were to pass and the client began to note the new experience of relevant missing symptoms, then the diagnosis of GAD would be