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Psychiatrie und Psychotherapie up2date 2008; 2(01): 33-43
DOI: 10.1055/s-2007-971025
Angststörungen, Zwangsstörungen und stressassoziierte Störungen

Diagnostik der Generalisierten Angststörungen

Thomas Bär
,
Michael Linden
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Kernaussagen

Die generalisierte Angststörung ist eine häufig auftretende psychische Erkrankung (Punktprävalenz: 1,2 - 3,7 %).

Das Leben der Patienten mit generalisierter Angststörung ist vor allem durch Sorge - „Worrying” geprägt. Diese ist von unspezifischen Symptomen wie erhöhter Muskelanspannung, Schlafstörungen, Reizbarkeit, Ruhelosigkeit, Konzentrationsschwierigkeiten oder Erschöpfbarkeit begleitet.

Der Verlauf der GAD ist in der Regel chronisch-persistent und durch Fluktuationen gekennzeichnet, wobei es unter Belastungen zu einer Exazerbation der Symptomatik kommen kann.

Um eine GAD erkennen und richtig diagnostizieren zu können, bedarf es eines guten Verständnisses dessen, was unter dem Leitsymptom des sich sorgens - „Worrying” zu verstehen ist und welche psychologischen Prozesse dabei wirksam werden.

Wichtig ist die Abgrenzung der GAD zu oft primär in der Krankheitsgeschichte als komorbide Erkrankungen gestellten Zusatzdiagnosen.



Publication History

Publication Date:
28 September 2007 (online)

© Georg Thieme Verlag KG Stuttgart · New York

 

  • Literatur

  • Carter RM, Wittchen HU, Pfister H, Kessler RC. One year prevalence of subthreshold and threshold DSM-IV generalized anxiety disorder in a nationally representative sample.. Depression and Anxiety 2001; 13: 78-88
    Search in Google Scholar
  • Lieb R, Becker ES, Altamura AC. The epidemiology of generalized anxiety disorder in Europe.. European Neuropsychopharmacology 2005; 15: 445-452
    Search in Google Scholar
  • Wittchen H, Hoyer J. Generalized anxiety disorder: nature and course.. Journal of Clinical Psychiatry 2001; 62: 15-21
    Search in Google Scholar
  • Kessler RC, Keller MB, Wittchen HU. The epidemiology of Generalized Anxiety Disorder.. The Psychiatric Clinics of North America 2001; 24: 19-39
    Search in Google Scholar
  • Linden M, Maier W, Achberger M, Herr R, Helmchen H, Benkert O. Psychische Erkrankungen und ihre Behandlung in Allgemeinarztpraxen in Deutschland. Ergebnisse aus einer Studie der Weltgesundheitsorganisation (WHO).. Der Nervenarzt 1996; 67: 205-215
    Search in Google Scholar
  • Maier W, Gansicke M, Freyberger HJ, Linz M, Heun R, Lecrubier Y. Generalized anxiety disorder (ICD-10) in primary care from a cross-cultural perspective: a valid diagnostic entity?. Acta Psychiatrica Scandinavica 2000; 101: 29-36
    Search in Google Scholar
  • Wittchen H-U, Kessler RC, Beesdo K, Krause P, Höfler M, Hoyer J. Generalized anxiety and depression in primary care: prevalence, recognition and management.. Journal of Clinical Psychiatry 2002; 63 (8): 24-34
    Search in Google Scholar
  • WHO. Internationale Klassifikation psychischer Störungen (ICD-10 Kapital V.. Übersetzung: Dilling H, Mombour W, Schmidt MH. Verlag Hans Huber 1993
    Search in Google Scholar
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.. Washington D.C.: American Psychiatric Association 1994
    Search in Google Scholar
  • Wittchen HU, Kessler RC, Zhao S, Abelson J. Reliability and clinical validity of UM-CIDI DSM-III-R generalized anxiety disorder.. Journal of Psychiatric Research 1995; 29: 95-110
    Search in Google Scholar
  • Ruscio A, Lane M, Roy-Byrne P. et al. Should excessive worry be required for a diagnosis of generalized anxiety disorder? Results from the US National Comorbidity Survey Replication.. Psychological Medicine 2005; 35: 1761-1772
    Search in Google Scholar
  • Stein MB. Public Health Perspectives on Generalized Anxiety Disorder.. Journal of Clinical Psychiatry 2004; 65 (Suppl 13): 3-7
    Search in Google Scholar
  • Carbone LA, Barsky AJ, Orav EJ. et al. Psychiatric Symptoms and Medical Utilization in Primary Care Patients.. Psychosomatics 2000; 41: 512-518
    Search in Google Scholar
  • Kessler RC, Greenberg PE, Mickelson KD, Meneades LM, Wang PS. The effects of chronic medical conditions on work loss and work cutback.. J Occup Med 2001; 43: 218-225
    Search in Google Scholar
  • Marciniak MD, Lage MJ, Dunavevich E. et al. The cost of treating anxiety: the medical and demographic correlates that impact total medical costs.. Depress Anxiety 2005; 21: 178-184
    Search in Google Scholar
  • Borkovec TD. The nature, functions, and origins of worry. In: Davey GLC, Tallis F (eds) Worrying: perspectives on theory, assessment, and treatment.. Chichester, Wiley: 1974
    Search in Google Scholar
  • Borkovec TD, Ray WJ, Stöber J. Worry: a cognitive phenomenon intimately linked to affective, physiological, and interpersonal behavioral processes.. Cognitive Therapy and Research 1998; 22: 561-576
    Search in Google Scholar
  • Aikins DE, Craske MG. Cognitive theories of generalized anxiety disorder.. The Psychiatric Clinics of North America 2001; 24: 57-74
    Search in Google Scholar
  • Turowski G, Barlow DH. Generalisiertes Angstsyndom. In: Margraf J (Hrsg) Lehrbuch der Verhaltenstherapie, Bd. 2.. Berlin, Springer: 1996
    Search in Google Scholar
  • Yonkers KA, Warshaw MG, Massion AO, Keller MB. Phenomenology and Course of Generalized Anxiety Disorders.. British Journal of Psychiatry 1996; 168: 308-313
    Search in Google Scholar
  • Hoyer J, Beesdo K, Becker ES, Wittchen HU. Epidemiologie und nosologischer Status der Generalisierten Angststörung.. Zeitschrift für Klinische Psychologie und Psychotherapie 2003; 32 (4): 267-275
    Search in Google Scholar
  • Roemer L, Molina S, Borkovec TD. An investigation of worry content among generally anxious individuals.. Journal of Nervous and Mental Disease 1997; 185: 314-319
    Search in Google Scholar
  • Craske MG, Rapee RM, Jackel L, Barlow DH. Qualitative dimensions of worry in DSM-III-R generalized anxiety disorder subjects and nonanxious controls.. Behaviour Research and Therapy 1989; 27: 397-402
    Search in Google Scholar
  • Breitholtz E, Johansson B, Öst LG. Cognitions in generalized anxiety disorder and panic disorder patients. A prospective approach.. Behaviour Research and Therapy 1999; 37: 533-544
    Search in Google Scholar
  • Hoyer J, Becker ES, Roth WT. Characteristics of worry in GAD patients, social phobics, and controls.. Depression and Anxiety 2001; 13: 89-96
    Search in Google Scholar
  • Henry JD, Phillips LH. Covariates of production and perseveration on tests of phonemic, semantic and alternating fluency in normal aging.. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2006; 13: 529-551
    Search in Google Scholar
  • Eysenck MW. Cognitive processing of the anxiety disorders.. New York: Wiley 1992
    Search in Google Scholar
  • Mogg K, Mathews A, Eysenck MW. Attentional bias to threat in clinical anxiety states.. Cognition and Emotion 1992; 6: 149-159
    Search in Google Scholar
  • Altrocchi J, Palmer J, Hellmann R, Davis H. The Marlowe-Crowne, repressor-sensitizer, and internal-external scales and attribution of unconscious hostile intent.. Psychol Rep 1968; 23 (3): 1229-1230
    Search in Google Scholar
  • Hoehn-Saric R. Psychic and somatic anxiety: worrries, somatic symptoms and physiological changes.. Acta Psychiatrica Scandinavica 1998; 98: 32-38
    Search in Google Scholar
  • Joormann J, Stöber J. Somatic symptoms of generalized anxiety disorder from the DSM-IV: associations with pathological worry and depression symptoms in a nonclinical sample.. Journal of Anxiety Disorders 1999; 13: 491-503
    Search in Google Scholar
  • Thayer JF, Friedman BH, Borkovec TD. Autonomic characteristics of generalized anxiety disorder and worry.. Biological Psychiatry 1996; 39: 255-266
    Search in Google Scholar
  • Stöber J. Besorgnis und Besorgtheit. Untersuchungen über Problemräume, deren Strukturierung und Elaboration.. Frankfurt: Lang 1996
    Search in Google Scholar
  • Borkovec TD, Inz J. The nature of worry in generalized anxiety disorder: a predominance of thought activity.. Behaviour Research and Therapy 1990; 28: 153-158
    Search in Google Scholar
  • Dyck IR, Phillips KA, Warshaw MG. et al. Patterns of personality pathology in patients with generalized anxiety disorder, panic disorder with and without agoraphobia, and social phobia.. Journal of Personality Disorders 2001; 15: 60-71
    Search in Google Scholar
  • Brawman-Mintzer O, Lydiard RB. Generalized anxiety disorder: issues in epidemiology.. Journal of Clinical Psychiatry 1996; 57 (Suppl 7): 3-8
    Search in Google Scholar
  • Hamilton M. The assessment of anxiety states by rating.. Br J Med 1995; 32: 50-55
    Search in Google Scholar
  • Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory (Form Y Self-evaluation questionnaire).. Palo Alto: Consulting Psychologists Press 1983
    Search in Google Scholar
  • Bär T, Zubrägel D, Linden M. Generalisierte Angststörungen und Depressionen: Psychometrische Erfassung von Sorgen.. MedReview 2001; 2: 20-21
    Search in Google Scholar
  • Bär T, Zubrägel D, Linden M. Die Formale Aspekte von Sorgen - Ratingskala (FAS-Rating). In: Hoyer J, Margraf J (Hrsg) Angstdiagnostik: Grundlagen und Messverfahren.. Berlin, Springer: 2002
    Search in Google Scholar
  • Meyer TJ, Miller ML, Metzger RL, Borcovec TD. Development and validation of the Penn State Worry Questionnaire.. Beh Res Ther 1990; 28: 487-495
    Search in Google Scholar