Clinical Manifestations and Diagnostic Criteria

- The clinical manifestations of anxiety disorders vary depending on the type, severity, and duration of the disorder. 

- However, some common signs and symptoms include

• Cognitive: irrational or excessive fear, worry, or nervousness; difficulty concentrating or remembering; negative or catastrophic thinking; confusion or disorientation
• Behavioral: avoidance of feared situations or objects; restlessness or agitation; compulsive or repetitive behaviors; impaired social or occupational functioning; increased use of coping mechanisms such as smoking, drinking, or overeating
• Physical: palpitations, chest pain, dyspnea, hyperventilation, sweating, trembling, nausea, diarrhea, dizziness, headache, insomnia, fatigue, muscle tension

- The diagnostic criteria for anxiety disorders are based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which provides specific features and duration for each type of disorder

- For example:

• Generalized anxiety disorder (GAD): excessive and persistent worry about various aspects of life for at least 6 months that is difficult to control and causes significant distress or impairment
• Panic disorder (PD): recurrent and unexpected panic attacks that are followed by at least 1 month of persistent concern or fear about having another attack or its consequences
• A panic attack is a sudden surge of intense fear or discomfort that reaches a peak within minutes and is accompanied by at least four physical or cognitive symptoms
• Phobias: marked and persistent fear of a specific object or situation that provokes immediate anxiety and avoidance behavior that is out of proportion to the actual danger posed by the object or situation
• . 
• Phobias can be classified into three types: specific phobia (e.g., fear of animals), social phobia (e.g., fear of public speaking), and agoraphobia (e.g., fear of open spaces)
• Obsessive-compulsive disorder (OCD): presence of obsessions and/or compulsions that are time-consuming (more than 1 hour per day) and cause significant distress or impairment
• . Obsessions are recurrent and intrusive thoughts, images, or impulses that cause anxiety. 
• Compulsions are repetitive behaviors or mental acts that are performed to reduce anxiety caused by obsessions.
• Post-traumatic stress disorder (PTSD): exposure to a traumatic event that involved actual or threatened death, serious injury, or sexual violence that causes persistent re-experiencing of the event (e.g., flashbacks), avoidance of stimuli associated with the event (e.g., places), negative alterations in cognition and mood (e.g., guilt), and increased arousal and reactivity (e.g., hypervigilance) for more than 1 month after the event
• Acute stress disorder (ASD): similar to PTSD, but the symptoms last from 3 days to 1 month after the traumatic event