Generalized anxiety disorder: a literature review

Inga Ruželytė1, Titas Petruša1, Miglė Sidaraitė1

1Lithuanian University of Health Sciences, Faculty of Medicine


Today‘s life rhythms and demands are often challenging and require intense physical and psychological efforts. An individual react to mental and physical strain by activating interconnected neuroendocrine circuits. This response allows the body to deal with the challenge and re-establish homeostatic equilibrium. If the strain is too intense or its duration is too long, maladaptation may occur. In this case, the stress response does not resolve into a state of balance, neuroendocrine parameters remain altered, and illness may ensue. Stress causes both physical and psychological symptoms. Physical symptoms include high heart rate, perspiration, chest pain, digestive problems, headache, muscle tension and pain. Psychological symptoms maybe anger, lowered mood, apathy, low energy levels, irritability, problems while trying to concentrate, insomnia, lack of motivation. It is thought that response to stress depends on the individual perception of the stressor if he thinks he can control it. The way a person can anticipate a certain stressor and adapt, largely defines the resulting stress response.  This implies that not all stimuli that induce strong neuroendocrine responses are a real stressor, but only those that exceed the individual‘s ability to change and adapt. Cortical centers in the brain sense a disturbing stimulus and respond by activating the sympathetic-adrenal-medullary axis, the renin-angiotensin systems, and later the hypothalamus-pituitary-adrenal axis. Andrenaline, other hormones and neuropeptides are produced and regulate cardiovascular and metabolic functions (for instance, increases in heart rate, breath frequency, glucose release) for a response to overcome the challenge. Therefore in today‘s life enriched with chronic stress anxiety disorders become relevant topics. Generalized anxiety disorder is a disease, characterized by a generalized, non-related to an event or situation anxiety and persistent worrying that is hard to control. The disease includes psychological and somatic symptoms.  Epidemiological studies of European countries representative samples have found a lifelong prevalence of generalized anxiety disorder of 4,3% to 5,9% of the population. Comorbidity with major depression and bipolar disorder has been observed in the majority of cases of generalized anxiety disorder. Treatment consists of pharmacological treatment, psychotherapy or both methods combined.

Keywords: generalized anxiety disorder, anxiety disorders, psychiatric disorders