Often these symptoms are substituted for ...

Often, these symptoms replace the patient's feelings of anxiety as such. He's more than 100 years ago, first described the "alarming neurosis" [70]. Somatic manifestations of anxiety, as well as acute and chronic stress and depression often occur in such socio-cultural communities, where mental disorders are considered "unacceptable", "indecent" and physical illness - "a disaster", "disaster", which may cause sympathy help and support of others. In addition, the "somatization" anxiety predisposes a number of constitutional, acquired, and external factors such as psychological warehouse person, especially bodily sensitivity, prolonged stress, as well as the so-called alexithymia (lack of human ability to recognize and express their own feelings). Clinic Somatic manifestations of chronically high levels of anxiety are varied and include symptoms associated with chronic muscle tension - headaches, myalgia, back pain and lower back (often are treated as "osteochondrosis"), muscle twitching, etc. Often, the only complaint with GAD is persistent weakness, also caused by chronic muscle tension. In addition, for a variety of anxiety are very characteristic vegetative symptoms: palpitations (up to paroxysmal tachycardia), disruption of the heart, a feeling of constriction or compression of the chest, cardialgia, feeling short of breath, increased blood pressure, tremors, abdominal cramps, dry mouth, excessive sweating, nausea, diarrhea, pallor or redness, "goose" skin ". Frequent as dizziness, pruritus, urticaria, bronchospasm, sexual dysfunction. Physician should not be tricked by the fact that patients often feel anxiety secondary to somatic symptoms ("felt terrified that his heart stopped," afraid that faint "). In fact, anxiety in such cases is the primary, and somatic manifestations - its symptoms, not causes. Less than 20% of patients with GAD themselves point typical psychological symptoms of anxiety [12] - insecurity, anxiety, permanent "planning", sverhkontrolya situation, "keyed up", for identifying patients to actively ask questions. The ability to detect possible somatic symptoms of anxiety is important for physicians somatic specialties for two reasons: - the need for differential diagnosis of GAD and somatic diseases - they are often combined with each other. Diagnostic criteria GTRpredstavleny in Table 1. The main clinical feature of GAD is a constant tension, apprehension, fearfulness, undue anxiety for various reasons (for example, about the delay, the quality of performance, light physical ailments, the safety of children, financial issues, etc.). In recent years, it is believed that the cardinal feature of patients with GAD is that they absolutely can not tolerate uncertainty [24]. Of all the possible scenarios of GAD patients presuppose the worst, although in principle possible.