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Tests and Diagnosis for Anxiety Disorders

By Friedemann Schaub, M.D., Ph.D. ; Updated August 14, 2017

There are a variety of tests and assessments psychiatrists employ to evaluate a person for an anxiety disorder. However, since many anxiety symptoms are similar to those of other medical conditions, see your primary care doctor first to make sure your symptoms are not caused by another illness.

See Your Primary Care Doctor

Many people first notice their anxiety as physical symptoms, such as heart palpitations, chest pain, difficulty breathing and profuse sweating. While these symptoms are usually harmless, it is important to consider that in some cases anxiety symptoms can indicate other medical conditions, such as heart disease, thyroid problems, diabetes and anemia, so a thorough physical exam is advised.

The doctor will also inquire about other contributing factors of anxiety disorders, such as family history, recent life changes, dietary habits, caffeine intake and alcohol and recreational drug consumption. Once physical illnesses have been ruled out, the next step is often a referral to a psychiatrist for further evaluation.

Tests Used by Psychiatrists

Many of the tests used by psychiatrists rely on the criteria documented in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to these diagnostic criteria, someone suffers from generalized anxiety disorder if he or she experiences: - Intense worry and anxious feelings during most days for at least six months. - Difficulties controlling the worry. - At least three of the following six symptoms: feeling restless or on the edge, fatigue, difficulty concentrating, irritability, muscle tension or sleep issues. One or more of these symptoms need to be present for most days of the week during the past six months. - Significant distress or impairment of daily life activities due to worry and anxiety. - Anxiety, which doesn’t focus predominantly on the worry of having a panic attack (as in panic disorder), getting humiliated by others (as in social anxiety disorder) or encountering a specific object or situation (as in phobias). - Worry and anxiety that are not related to physiological illnesses, substance abuse or other mental-health conditions.

Tests Used to Diagnose the Severity of Anxiety

Doctors often use one of the following tests to more accurately evaluate the severity of the anxiety: - Hamilton Anxiety Scale (HAM-A) The HAM-A test involves 14 questions that assess moods, fears, tension, sleep, physical, intellectual and behavioral symptoms on a scale from 0 (not present) to 4 (severe prevalence). - Beck Anxiety Inventory (BAI) This test includes 21 questions, which evaluate to what extent a person has experienced common anxiety symptoms during the past week. The symptoms, such as numbness, tingling, sweating and fear are rated as “not at all,” “mildly,” “moderately,” or “severely.” - Penn State Worry Questionnaire With 16 questions, this widely used test measures the intensity, controllability and frequency of worry. It is also utilized to discern between generalized anxiety disorder and social phobia.

Other Diagnostic Factors

Besides diagnosing the severity of the anxiety disorder, the psychiatrist also examines whether a person is dealing with other frequently co-occurring mental illnesses, such as depression, bipolar disorder and ADHD.

It is difficult for many people to distinguish whether their anxiety is an appropriate reaction to a specific difficult circumstance, or whether they are dealing with an anxiety disorder. If you have been continuously anxious for several months and find that your worries and emotions consume your energy and affect your ability to function, the first step to find relief is to visit your doctor to get an accurate diagnosis.

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