(1) Excessive anxiety and worry, occurring more days than not for at least 6 months.
(1) Stiffness in the axial muscles, particularly abdominal and thoracolumbar paraspinal muscles, leading to a fixed deformity: hyperlordosis. (2) Superimposed painful spasms precipitated by unexpected noises, emotional stress, or tactile stimuli. (3) Confirmation by electromyography (EMG). (4) Absence of neurological or cognitive impairment that could explain the stiffness. (5) Positive serology: GAD or amphiphysin autoantibodies. (6) Response to diazepam.
(2) The individual finds it difficult to control the worry.
(3) The anxiety and worry are associated with three or more of the following:
(a) Restlessness and feeling keyed up or on edge
(b) Being easily fatigued
(c) Difficulty concentrating or mind going blank
(d) Irritability
(e) Muscle tension
(f) Sleep disturbances
(4) Symptoms cause significant distress or impairment in social, occupational, or other areas of functioning.
(5) Symptoms are not attributable to the physiological effects of a substance or another medical condition.
(6) Symptoms are not explained by another mental disorder.
(1) Table adapted from DSM-V criteria for generalized anxiety disorder [5]. (2) Table adapted from Dalakas criteria for SPS [6]. Note. Text in italic represents symptoms/signs for the patient, meeting criteria for both GAD and SPS.
