Anxiety differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

Anxiety must be differentiated from other diseases that cause anxiety such as major depressive disorder, bipolar disorder, atypical psychosis, schizophrenia, other medical and neurologic conditions.

Differential diagnosis

Anxiety must be differentiated from below causes:

psychiatric	Cardinal features
Major depressive disorder	DSM major depressive disorder (MDD) diagnostic criteria require the occurrence of one or more major depressive episodes. Symptoms of a major depressive episode include the following: Depressed mood Anhedonia (diminished loss of interest or pleasure in almost all activities) Significant weight or appetite disturbance (read more about: Depression and Weight Gain, Weight Loss) Sleep disturbance Psychomotor agitation or retardation (a speeding or slowing of muscle movement) Loss of energy or fatigue Feelings of worthlessness (low self-esteem) Diminished ability to think, concentrate and make decisions Recurrent thoughts of death, dying or suicide Longstanding interpersonal rejection ideation (ie. others would be better off without me); specific suicide plan; suicide attempt. The DSM states either a depressed mood or anhedonia must be present. In addition to the above DSM criteria for a major depressive episode, the episode must: Be at least two weeks long Cause significant distress or severely impact social, occupational or other important life areas Not be precipitated by drug use Not meet the criteria for another mental disorder like schizophrenia or bipolar disorder Not be better explained by bereavement (such as the loss experienced after a death)
Bipolar I disorder	Angina pectoris
Atypical psychosis	Hyperventilation
Schizophrenia	Hypoglycemia
Substance abuse	Hyperthyroidism
Cognitive disorders	Carcinoid