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Sunday, November 17, 2019

Medically-induced Anxiety Disorder

Sometimes during the course of a medical illness it is possible to develop an anxiety disorder that is etiologically associated with the medical illness. The most well-known medical illnesses that can produce anxiety disorders are:

  1. hyperthyroidism
  2. pheochromocytoma
  3. hypoglycemia 
  4. hyperadrenocortisolism 
  5. congestive heart failure 
  6. pulmonary embolism 
  7. atrial fibrillation 
  8. chronic obstructive pulmonary disease
  9. asthma 
  10. pneumonia 
  11. vitamin B12 deficiency
  12. porphyria       
  13. neoplasms
  14. vestibular dysfunction
  15. encephalitis
  16. seizure disorders 

The fact that a patient with a medical illness that can produce an anxiety disorder is actually diagnosed with an anxiety disorder, does not mean that the anxiety disorder is necessarily attributable to the medical illness. Many factors must be taken into account before the clinician decides that the anxiety disorder of the patient is etiologically related to the medical illness.

For instance, the patient who is simultaneously diagnosed with a neoplasm and an anxiety disorder does not necessarily suffer from a neoplasm-induced anxiety disorder. More specifically, if the patient often presented in the past a clinical picture that met the criteria for an anxiety disorder before or during a major medical examination, it is accurate to explain the anxiety disorder of the patient to the pathophysiological effects of the neoplasm and to psychological factors that preceded the input of the pathophysiology of the neoplasm. On the contrary, if the patient rarely presented anxiety related symptoms, before the diagnosis of the neoplasm, the anxiety disorder might be safely categorized as a medically-induced anxiety disorder.

The implications of an accurate medically-induced anxiety diagnosis are decisive for the course of treatment of both medical and psychological disorders. For instance, the cancer patient with a positive prognosis who simultaneously suffers from illness anxiety disorder (description available under the somatic type section in this web site)  and not medically-induced anxiety disorder  may be less able to interpret positively his/her treatment of cancer, because of the interference of the illness anxiety disorder psychology.

Important notice (1): You should not reach the decision that you or the person you have in mind, when reading the above clinical description, suffers from a medically-induced anxiety disorder. We encourage you to seek professional advice, if you feel that you or the persons you care about meet one or more of the clinical criteria.

Important notice (2): In cases of a life-threatening medical illness, it is of the outmost importance to accurately diagnose any comorbid anxiety disorder and urgently controlling it, for allowing the patient the possibility of an optimal response to the life-threatening medical illness.

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