Differential Diagnosis
Other
psychiatric disorders such as major depression should be assessed as patients
may also present with mixed anxiety-depressive disorder.
Medical
Illness
In
anxiety disorders, it is important to evaluate for underlying disorders that
may cause symptoms of anxiety such as hyperthyroidism, hypothyroidism,
Cushing’s disease, cardiovascular disease, respiratory disease, mitral valve
prolapse, etc. The illness is then treated appropriately.
Substance
Abuse or Medication Use
Withdrawal
or use of addictive substances that may cause anxiety (eg caffeine, nicotine,
alcohol, illegal substance) is inquired. Misuse of alcohol or drugs may be an
attempt to reduce anxiety in patients with social
anxiety disorder. History of medications that may cause anxiety (eg steroids,
selective serotonin reuptake inhibitors [SSRIs], Thyroxine, Theophylline,
herbal products) is obtained. Patients should be assessed for substance abuse
as this may be a complication of generalized
anxiety disorder.