Anxiety Disorder

Anxiety Disorder 

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Introduction

Anxiety disorder is a mental and emotional condition associated with high levels of distress, nervousness, worry, and fear. Many people experience anxiety attacks at particular times in their lives. However, when not handled well, it becomes a medical condition that can cause severe life-threatening issues (Koyuncu, İnce, & Ertekin et al., 2019).Researchers, therapists, and doctors have developed the most effective and appropriate assessment and treatment options to help patients suffering from an anxiety disorder. Some of the most effective assessment tools that mental health professionals use to assess and measure the severity of anxietyin an individual include Generalized Anxiety Disorder 7-item (GAD-7)and Hamilton Anxiety Scale (HAM-A).

Anxiety Impacts on The Body, Mind, And Spirit of An Individual

If not handled properly, anxiety impacts an individual’s body, mind, and spiritual well-being. Some of the impacts anxiety can pose to the body include increased heart rate, shortness of breath, fatigue, headache, and sweating. High heart rates and poor breathingresult fromadrenalin hormones released by the body during anxiety. Additionally, during anxiety attacks, the body muscles tend to become rigid, making the body strain hence causing headaches and fatigue (Koyuncu, İnce, & Ertekin et al., 2019).When it comes to the mind, anxiety triggers stress hormones in the brain, which impacts the logical thinking of an individual. As the stress levels continue to be released, they result in depression which is among the serious conditions in the brain. Not only does anxiety threaten one’s body and mind, but it also affects one’s spiritual well-being as it instills fear in an individual, thus limiting how someone enjoys life. People with anxiety tend to isolate themselves from their normal surroundings because it makes them feel hopeless. Therefore, it is important for medical professionals to fully assess anxiety victims to provide the correct medication.

The Basic Features of GAD-7 and HAM-A.

GAD-7 is an assessment tool developed to assess and screen the severity of symptoms associated with generalized anxiety disorder (GAD). It comprises seven items that help identify the presence of certain anxiety features in a patient. This item is widely used in care settings since it easily identifies GAD symptoms within a short period as it contains questions that a patient answers to determine the anxiety score (Sapra, Bhandari, &Sharma et al., 2020). The common basic features of the GAD-7 tool include its ability to detect a feeling of nervousness, anxiousness, worrying too much about different things, and the ability to control worrying. Other features include the ability to detect the patient’s trouble relaxing, restlessness, irritability level, and fear about life as if something awful might happen.Measurement-based care emphasizes the use of GAD-7 assessment to help guide treatment decisions as it helps monitor improvements or changes in mental health symptoms.

HAM-A is another assessment tool used in clinical and research settings to measure the severity of anxiety symptoms. The most common features of HAM-A include its ability to use the fourteen parameters to detect the severity of anxiety. The Hamilton scale is a psychological questionnaire clinician use to measure anxious mood, tension, fears, insomnia, and somatic complaints in patients. The scale of the fourteen parameters comprises a series of symptoms and measures psychic and somatic symptoms associated with anxiety (Saragih & Rahmawati, 2020). However, although HAM-A remains one of the most used tools in assessing anxiety, it has received critics due to its inability to differentiate anxiolytic effects from antidepressant effects, as well as somatic anxiety versus somatic side effects. However, despite the criticisms, HAM-A is still accepted due to its reported levels of interrater reliability.

Similarities BetweenGAD-7 and HAM-A.

The similarity between the two assessment tools is that they are both self-rating scales as they both use questionnaires to measure the severity of anxiety. The common basic features in GAD-7 and HAM-A include the ability to detect a feeling of nervousness, anxiousness, worrying too much about different things, the ability to control worrying, the ability to detect the patients’ trouble relaxing, restlessness, irritability level, and their feeling of being afraid about life as if something awful might happen. Additionally, both GAD-7 and HAM-A are suitable for general hospitals for non-psychiatrists and psychologists’ measures. Thus, the anxiety levels of patients can easily be detected, helping them determine whether to refer the patients to a mental and psychological specialist or treat them with medications.

Differences BetweenGAD-7 and HAM-A.

The major difference between HAM-A and GAD-7 is that HAM-A cannot differentiate between anxiolytic and antidepressant effects. Also, the subscale of anxiety is strongly related to the side effects of higher compared to insomnia. On the contrary, GAD-& scale can possibly differentiate between anxiolytic and antidepressant effects due to the many questions a client is asked (Sapra, Bhandari, &Sharma et al., 2020). Another difference is that the GAD-7 scale focuses on only one anxiety disorder, forgetting that different patients suffer from various anxiety disorders. On the contrary, HAM-A can detect different types of anxiety because it is divided into two subscales measuring physical and mental anxiety.

What Might Cause A Mental Health Professional to Select HAM-A Over GAD-7

Clinicians must be highly trained and skilled in usingthe HAM-A scale,which also takes longer than GAD-7. Therefore, for patients with few anxiety symptoms, the doctor might decide to use GAD-7 as it is easy to use and quicker to screen anxiety results. Additionally, based on the patient’s education level, a doctor might decide to use one assessment tool over the other. For instance, since GAD-7 is a self-rating scale, the assessment results may be affected by the cognitive function of the patients, affecting the results’ accuracy. In such cases, healthcare professionals might decide to use HAM-A due to its reliability and accuracy as it involves the assessment of somatics from different body parts, emotions, and behaviors.

References

Koyuncu, A., İnce, E., Ertekin, E., & Tükel, R. (2019). Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs in context, 8.

Sapra, A., Bhandari, P., Sharma, S., Chanpura, T., & Lopp, L. (2020). Using generalized anxiety disorder-2 (GAD-2) and GAD-7 in a primary care setting. Cureus, 12(5).

Saragih, J. I., & Rahmawati, E. (2020). The Accuracy of the Indonesian Version of HAM-A. Universitas Sumatera Utara, 7, 1545-1549.