Talk:Anxiety

Lancet seminar

doi:10.1016/S0140-6736(16)30381-6 JFW | T@lk 08:26, 2 September 2016 (UTC)

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Recent reversion

About this reversion [1], is not justified.

The previous version included a closed, very limited, and no properly representative list of health disorders which may cause anxiety symptoms. I organized and expanded the list a bit, adding at least some of the most representative disorders, with sources which meet WP:MEDRS. My edit also meets WP:NPOV and WP:RSUW.

The most important approach to people with anxiety symptoms is to confirm or rule out the presence of an underlying organic disorders causing their symptoms, whose diagnosis and treatment should be the main objective. It is the most important point and one that is often forgotten. Increasing evidence confirms that many neuropsychiatric diseases mask an underlying organic disorder.

This reference Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases is very complete, free-access, with demonstrative tables, and better than this other already present [2] (I wonder if we should eliminate it...).

The inclusion of non-celiac gluten sensitivity in the list, possibly what has bothered Jytdog most, is fully justified since its estimated prevalence is very high (rates between 0.5–13% in the general population), higher than that of many of the diseases listed in the previous version and anxiety is one of the most common of its extraintestinal symptoms. The date of the review is 2015 and is published in the journal Best Practice & Research Clinical Gastroenterology, with an impact factor of 3.478. (I extracted a brief quotation because is not free access (edited on November 14: I just found the link to the free full text), to avoid future doubts). We can see the relevance in this table with epidemiological data of some other diseases of the list:

Comparative table

Disease Epidemiology (copied from current versions of Wikpedia articles) Non-celiac gluten sensitivity Rates between 0.5–13% in the general population Asthma Rates vary between countries with prevalences between 1 and 18% Chronic obstructive pulmonary disease Globally, as of 2010, COPD affected approximately 329 million people (4.8% of the population). Diabetes The prevalence of diabetes is 8.5% among adults. Hypotiroidism In large population-based studies in Western countries with sufficient dietary iodine, 0.3–0.4% of the population have overt hypothyroidism. Hyperthyroidism In the United States hyperthyroidism affects about 1.2% of the population. Cardiac arrhythmia In Europe and North America, as of 2014, atrial fibrillation affects about 2% to 3% of the population. Celiac disease Rates vary between different regions of the world, from as few as 1 in 300 to as many as 1 in 40, with an average of between 1 in 100 and 1 in 170 people. Anemia A moderate degree of iron-deficiency anemia affected approximately 610 million people worldwide or 8.8% of the population. Epilepsy It affects 1% of the population by age 20 and 3% of the population by age 75. Multiple sclerosis As of 2010, the number of people with MS was 2–2.5 million (approximately 30 per 100,000) globally, with rates varying widely in different regions Parkinson's disease The proportion in a population at a given time is about 0.3% in industrialized countries. PD is more common in the elderly and rates rises from 1% in those over 60 years of age to 4% of the population over 80. Alzheimer's disease In the United States, Alzheimer prevalence was estimated to be 1.6% in 2000 both overall and in the 65–74 age group, with the rate increasing to 19% in the 75–84 group and to 42% in the greater than 84 group. Prevalence rates in less developed regions are lower.

Jytdog, I repeat that I respect your work very much and I believe that it is very valuable, but I tell you once again that you are confused with me and I ask you once again please stop harassing me with such type of comments [3].

I'm going to restore the edit. And in my opinion, it would be advisable to make a broader listing, perhaps a table.

Best regards. --BallenaBlanca (Talk) 05:25, 12 November 2016 (UTC)

References

Yes the current content is not good. "anxiety" - the emotion - is a common human reaction to bad situations, especially serious medical conditions, especially chronic ones or terminal ones. and especially when there is a lot of uncertainty as there is often is in medicine. the content should be more clear about that. it is also a direct result of things like traumatic brain injury. am looking for sources that deal with this generally and clearly. the laundry-list approach to listing medical conditions "associated" with anxiety is not productive. Jytdog (talk) 05:49, 12 November 2016 (UTC)

I had not read this before my last edit here. Well, we'll continue talking, now I do not have more time. Best regards. --BallenaBlanca (Talk) 06:01, 12 November 2016 (UTC)

Do we have data on how common anxiety is in each of these conditions? Anxiety is a normal human emotion felt by all so would be present in all diseases as well as all healthy people. I guess the question is which ones have significantly higher rates? During an MI or during an asthma exacerbation nearly everyone is seriously anxious. Those with well controlled asthma who are not having a flair are not anxious. Doc James (talk · contribs · email) 23:37, 12 November 2016 (UTC)

True, no one needs to read an encyclopedia to know that being sick can trigger anxiety symptoms. I think the approach is when anxiety may be masking an organic disease, anxiety as one of the first symptoms of an active disease, and focusing on differential diagnosis. We would have the following list:

Endocrine diseases (hypothalamic diseases, hyperprolactinemia, hypo- and hyperthyroidism), metabolic disorders (diabetes), deficiency states (low levels of vitamin D, B2, B12, PP and folate), electrolytes disorders (parathyroid diseases), respiratory diseases (chronic obstructive pulmonary, asthma, pulmonary edema, pulmonary embolism), heart diseases, haematologic diseases (sickle cell, anemia), gastrointestinal diseases (celiac disease, non-celiac gluten sensitivity, inflammatory bowel disease, Crohn’s disease, Whipple‘s disease), inflammatory diseases (systemic lupus erythematosus), infectious diseases (enteric typhoid fever, infectious mononucleosis), cerebral vascular accidents (transient ischemic attack, stroke), brain infectious diseases (meningitis, encephalitis), brain degenerative diseases (Alzheimer‘s disease, Parkinson's disease, dementia, Huntington’s disease, multiple sclerosis, epilepsy)

Extended content / prevalence

Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases Endocrine Diseases The hypothalamic diseases cause most frequently bulimia or anorexia, hypersomnia, impotency, and attacks of anxiety. Effects of hyperprolactinemia on mood and behaviour include depression, eating disorders and anxiety. Metabolic Disorders Reactive hypoglycemia is often considered the cause of anxiety symptoms in diabetic patients. Actually, hypoglycemia presents with symptoms related to autonomic activation, involving the psychic field with behavioural disorders and anxiety (adrenergic symptoms), and related to neuronal suffering (neuro-glycopenic symptoms), with predominant implication of cognitive (speech difficulty), sensorial (visual disorders, dizziness) and neuromuscular (fatigue) sphere. Deficiency states Low levels of vitamin D have been associated with exacerbation of anxiety, depression, psychosis. Low levels of vitamin B2, B12, PP and folate. Electrolytes Disorders Parathyroid diseases often present with psychiatric symptoms, and can be easily recognized through determinations of low calcium levels. The link between anxiety disorders and hypocalcemia is mutual: a panic attack could manifest with tetany by hyperventilation, and hypocalcemia could trigger a panic attack. Medical history can reveal a renal failure or a past thyroidectomy, while electrocardiogram (ECG) shows low and large QRS complex and long QT duration. Moreover, arrhythmia, paresthesia, laryngospasm, muscle cramps and tetany (obstetrician’s hand) can appear. The increased central neuro-excitability produces instead irritability and seizures, but anxiety is the predominant symptom in 20% of patients. Respiratory Diseases Approximately one third of patients with chronic obstructive pulmonary disease meets the criteria for anxiety disorders, and a quarter shows depression, systemic inflammation being implicated in their pathogenesis, other than corticosteroids. An increased prevalence of depression, anger, anxiety disorders, particularly panic attacks, is also reported in patients with asthma, easily identified by thoracic objective alteration and pulse oximetry. Pulmonary edema and pulmonary embolism can present with choking sensation associated to anxiety and agitation, fear, sometimes sensation of forthcoming death. Heart Diseases Mitral valve prolapse can be associated with palpitations and induce anxiety. A significant proportion (about 20%) of ICD patients experiences psychological symptoms including anxiety, depression or both, a rate similar to that in other cardiac populations. Haematologic Diseases Sickle cell disease conveys a high risk of anxiety and depression, due to chronic anemia, hypoxiemia, cerebrovascular ischemia and stroke, Gastrointestinal diseases Neuropsychiatric disorders may precede the diagnosis of Crohn’s disease, including peripheral neuropathy, myopathies, pseudotumor cerebri, papilloedema and psychiatric disorders (anxiety, phobias, depression). Whipple‘s disease, a multisystemic chronic granulomatous disease caused by infection with Tropheryma whipplei, can appear as a primary neuropsychiatric isorder, including cognitive changes and psychi- atric findings (depression, anxiety, psychosis, personality change). Inflammatory and Infectious Diseases The immune system can influence the CNS by cytokines, produced by activated immune cells. Sickness behaviour is a behavioural complex induced by infectious and immune disease, and mediated by pro-inflammatory cytokines. It is an adaptive response that enhances recovery by conserving energy to combat acute inflammation. There are considerable phenomenological similarities between sickness behaviour and depression, for example, behavioural inhibition, anorexia, adipsy, increased sleepiness, melancholia (anhedonia), anxiety, and somatic symptoms (fatigue, hyperalgesia, malaise). Recently, depression and sickness behaviour have been proposed as Janus-faced responses to shared inflammatory pathways. Several neuropsychiatric pictures are related to systemic lupus erythematosus, without reliable imaging or laboratory criteria: cognitive deficit, anxiety, mood disorders, confusion, delirium, and psychosis. Psychiatric morbidity can affect about 20% of patients suffering enteric (typhoid) fever, appearing with delirium (73%), generalized anxiety disorder (4%), depressive episode (4%), schizophrenia like disorder (4%) and monosymptomatic neuropychiatric manifestations such as apathy, hallucination, confusion and coma. Anecdotal reports suggest that chronic fatigue, anxiety and depressive disorders may be precipitated by infectious mononucleosis. Cerebral Vascular Accidents Anxiety often accompanies a transient ischemic attack and may be the major symptom of presentation in emergency department. Aphasia, unilateral neglect, anosognosia (deficit disorders), delirium and mood disorders (productive disorders), are the most frequent disorders checked during first examination of stroke in emergency department. Anxiety and depression are associated with lefthemispheric strokes. The left-side neglect and anosognosia are the most widespread neuropsychiatric symtoms after the right cerebral hemisphere lesion, and anxiety alone is commonly associated. Brain Infectious Diseases Brain suffering in meningitis and encephalitis, mainly of viral or bacterial etiology, together with common irritative signs and various neurological deficits, involves consciousness alterations (from sleepiness to coma) and psychiatric symptoms simulating anxiety (restlessness), mood disorders or true psychosis (delirium). Brain Degenerative Diseases Anxiety symptoms, depression and changes in personality are common in Alzheimer‘s disease or other forms of dementia, and sometimes precede the other early clinical manifestations, such as cognitive impairment and mood changes. Psychiatric manifestations are an integral part of Huntington’s disease, including specific symptoms, such as the executive dysfunction syndrome, and not-specific symptoms, such as delirium. Anxiety and major depression have been reported as the most common prodromal symptom. Anxiety disorders are reported in 37% of patients with multiple sclerosis, but depression is the most frequently related disorder. In many cases multiple sclerosis is wrongly diagnosed as pure psychiatric disorder. Mood disorders are the most frequent conditions associated with epilepsy, followed by anxiety, attentiondeficit, psychotic and personality disorders. Patients with focal epilepsy, and mainly those arising from temporal and frontal lobe, have a greater incidence of anxiety (panic attacks), depression, or psychosis. Dementia should be considered in differential diagnosis in elderly patients, complaining psychiatric symptoms like severe anxiety manifestations, depressive or paranoic disorders, acute psychosis and marked agitation (“myxedema madness”) Celiac disease Psychological morbidity of celiac disease: A review of the literature Results: Anxiety, depression and fatigue are common complaints in patients with untreated celiac disease and contribute to lower quality of life. While aspects of these conditions may improve within a few months after starting a gluten-free diet, some patients continue to suffer from significant psychological morbidity. Psychological symptoms may affect the quality of life and the dietary adherence. Conclusion: The literature on the effect of treatment in the outcome of depression, anxiety, fatigue and QoL in CD is not consistent. However, it is important to consider that ongoing problems with anxiety and depression in particular may affect dietary adherence and QoL. Thus, health care professionals need to be aware of the ongoing psychological burden of CD in order to support their patients. The lack of clear evidence of improved QoL in asymptomatic CD after treatment makes mass screening, where a majority of patients may be subclinical or asymptomatic, controversial if the aim of screening is to improve QoL. Further studies are required to better understand this specific aspect. Non-celiac gluten sensitivity: Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders The most frequent extra-intestinal features of NCGS include fatigue and lack of well-being together with neurological symptoms, i.e. headache, “foggy mind”, arm / leg numbness and anxiety / depression. Systematic review: noncoeliac gluten sensitivity. Table 3 Extraintestinal manifestations (%): Anxiety 39% (Volta, 2014) Inflammatory bowel disease. Depression and anxiety in patients with Inflammatory Bowel Disease: A systematic review. Pooled prevalence estimate for anxiety disorders was 20.5% [4.9%, 36.5%] and 35.1% [30.5, 39.7%] for symptoms of anxiety. IBD patients in active disease had higher prevalence of anxiety of 75.6% [65.5%, 85.7%] compared to disease remission….. Results from this systematic review indicate that patients with IBD have about a 20% prevalence rate of anxiety and a 15% prevalence rate of depression. Chronic obstructive pulmonary disease Strategies to improve anxiety and depression in patients with COPD: a mental health perspective. Anxiety and depression are remarkably common in COPD patients, but the evidence about optimal approaches for managing psychological comorbidities in COPD remains unclear and largely speculative. Type 1 diabetes: Symptoms of depression and anxiety in youth with type 1 diabetes: A systematic review and meta-analysis. Symptoms of anxiety were reported for up to 32% of patients. A negative impact on glycemic control was demonstrated. CONCLUSIONS: Our analyses confirmed a high prevalence of symptoms of depression and anxiety in youth with type 1 diabetes that potentially compromise diabetes management and glycemic control. Type 1 or 2 diabetes The association between Diabetes mellitus and Depression There is evidence that the prevalence of depression is moderately increased in prediabetic patients and in undiagnosed diabetic patients, and markedly increased in the previously diagnosed diabetic patients compared to normal glucose metabolism individuals [7]. The prevalence rates of depression could be up to three-times higher in patients with type 1 diabetes and twice as high in people with type 2 diabetes compared with the general population worldwide [8]. Anxiety appears in 40% of the patients with type 1 or 2 diabetes [9]. The presence of depression and anxiety in diabetic patients worsens the prognosis of diabetes, increases the non-compliance to the medical treatment [10], decreases the quality of life [11] and increases mortality [12]. Hypothyroidism and hyperthyroidism Cognitive function in untreated hypothyroidism and hyperthyroidism. Also present are alterations in mood, manifested by increased rates of depressive and anxiety symptoms. SUMMARY: Patients with overt or subclinical thyroid dysfunction commonly complain of decrements in cognitive function, but studies suggest that such decrements are most likely to be minor or not related to the thyroid dysfunction. More common are mood alterations, which often improve with treatment. Epilepsy. Psychiatric comorbidities in epilepsy: identification and treatment. Mood disorders are the more frequent conditions associated with epilepsy, followed by anxiety, attention-deficit, psychotic and personality disorders. Multiple sclerosis. The incidence and prevalence of psychiatric disorders in multiple sclerosis: a systematic review. Among population-based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%-35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%-30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%-10.3%) for psychosis. CONCLUSION: This review confirms that psychiatric comorbidity, particularly depression and anxiety, is common in MS. Parkinson's disease Depression, anxiety, and apathy in Parkinson's disease: insights from neuroimaging studies. Depression, anxiety and apathy are common mood disturbances in Parkinson's disease (PD) but their pathophysiology is unclear. Alzheimer’s disease. The prevalence of neuropsychiatric symptoms in Alzheimer's disease: Systematic review and meta-analysis. The most frequent NPS was apathy, with an overall prevalence of 49% (95% CI 41-57%), followed by depression, aggression, anxiety and sleep disorder, the pooled prevalence estimates of which were 42% (95% CI 37-46%), 40% (95% CI 33-46%), 39% (95% CI 32-46%) and 39% (95% CI 30-47%), respectively.

Best regards. --BallenaBlanca (Talk) 04:48, 13 November 2016 (UTC)

References

This article is not about mood disorders. A bunch of those sources discuss mood disorders and some discuss depression, which is different emotion/mood. Again I do not think the laundry list approach is helpful. General content about how being sick (or dying) causes anxiety; maybe specific organs affected that tend to cause anxiety more commonly (diseases/conditions where it is hard to breathe (COPD, asthma, etc), appear to have high trend to cause anxiety, for example), or kinds of conditions -- for example degenerative conditions that have unpredictable courses (MS, ALS, for example). That sort of thing. Jytdog (talk) 05:13, 13 November 2016 (UTC)

Perhaps we could trim the list a bit. But you can not leave out gastrointestinal diseases, they are some of those that are clearly at the top as causing anxiety symptoms, and sometimes, anxiety is the only manifestation in abscense of digestive symptoms (or identificable digestive symptoms), as commonly occurs in CD and NCGS.

Endocrine diseases (hypothalamic diseases, hyperprolactinemia, hypo- and hyperthyroidism), metabolic disorders (diabetes), deficiency states (low levels of vitamin D, B2, B12, PP and folate), respiratory diseases (chronic obstructive pulmonary disease, pulmonary edema, pulmonary embolism), heart diseases, haematologic diseases (sickle cell, anemia), gastrointestinal diseases (celiac disease, non-celiac gluten sensitivity, inflammatory bowel disease), inflammatory diseases (systemic lupus erythematosus), cerebral vascular accidents (transient ischemic attack, stroke), brain infectious diseases (meningitis, encephalitis), brain degenerative diseases (Alzheimer‘s disease, Parkinson's disease, dementia, multiple sclerosis, Huntington’s disease, epilepsy)

Best regards. --BallenaBlanca (Talk) 13:10, 13 November 2016 (UTC)

We have now arrived at your unfortunately continuing effort to drive celiac into every article in WP. Stop it. Burying it in a laundry list is not acceptable. That said i think there is a pretty well known relationship between gut and anxiety, especially with somaticization of anxiety in various kinds of gut pain. We can discuss that at a high level. Jytdog (talk) 21:08, 13 November 2016 (UTC)

And we have now arrived at your continuing effort to remove mentions to celiac disease, non-celiac gluten sensitivity, and in general the possibility of improving disease symptoms with a diet management in every related disease in WP, specially neurological and psychiatric disorders. Perhaps your COI[4] is a problem and it's conditioning your approach and your edits. Stop pushing your POV, stop pushing against me or those who write about reversible diseases that can cause neurological or psychiatric symptoms, and stop harassing me, as I am asking you again and again and again....

Let's focus on this talk, please. WP:OFFTOPIC

And let's focus on the data and literature, as Doc James said, and let's see if they support my proposal. That's what we have to do.

You said: "That said I think there is a pretty well-known relationship between gut and anxiety, especially with somaticization of anxiety in various kinds of gut pain."

Yes, there is a pretty well-known relationship between gut and anxiety. But thinking about just somatization is a very, very simplistic vision, which does not reflect current knowledge.

Coeliac disease occurs frequently, affecting 1–3% of the Western population. In developed countries 83% of CD cases remain undiagnosed, usually because majority of patients may be subclinical or asymptomatic (non-classic, minimal, or absent digestive symptoms). Prevalence rates for NCGS are 0.5%-13%.

Extra-intestinal symptoms, as anxiety, may be the only manifestation of CD and NCGS in absence of gastrointestinal symptoms. Anxiety is a common complaint in patients with untreated celiac disease and contribute to lower quality of life, which usually improves within a few months after starting a gluten-free diet. Anxiety affects about 39% of people with untreated NCGS and dietary elimination of gluten may lead to complete symptoms resolution.

"There has been a tendency by some to attribute NCGS to placebo effect or somatization, particularly as the diagnosis is based on subjective self-reporting by patients. As well as the initial study confirming NCGS by Gibson et al. [22], however, an interesting study was recently published where groups of patients with CD, NCGS and a control group underwent complete psychiatric assessment and a subsequent gluten challenge [26]. There was found to be no difference between groups in their tendency to somatization, personality traits, or anxiety and depression symptoms. Moreover, patients with NCGS reported more symptoms than CD patients when challenged with gluten, suggesting NCGS to be a credible physical diagnosis [26]. Key Points: • Gluten ingestion in gluten sensitive individuals can lead to a variety of clinical presentations including psychiatric, neurological, gynecological, and cardiac symptoms. • Dietary elimination of gluten may lead to complete symptom resolution. • Health practitioners are advised to consider gluten elimination in patients with otherwise unexplained symptoms. • Nonceliac gluten sensitivity may be a part of a constellation of symptoms resulting from a toxicant induced loss of tolerance' (TILT).

And you're trying to avoid mentioning CD and NCGS and just talking about "somaticization of anxiety in various kinds of gut pain". Two chronic diseases which have such high prevalence in the general population, and such high rates of underdiagnosis, and many CD and NCGS people spend many years calified and managed as simply anxious and even they are not evaluated. There is no justification. We can not stop talking about this just because you do not like it. It's your POV.

We have enough data to support and include the list I proposed.

What I propose you is that you add more gastrointestinal diseases if you consider it and locate data, but in addition to CD and NCGS.

Best regards. --BallenaBlanca (Talk) 09:35, 14 November 2016 (UTC)

References

am not trying to avoid CD at all - a laundrylist is still not helpful and all the walls of text in the universe are not going to change that. i got hung up on several other things this weekend. will come back after looking for general sources on anxiety and disease. Jytdog (talk) 10:02, 14 November 2016 (UTC)

Jytdog I don't understand what this you say "i got hung up on several other things this weekend" means. --BallenaBlanca (Talk) 13:23, 14 November 2016 (UTC)

i wanted to spend time on this; i ended up spending time on other things instead. Jytdog (talk) 20:04, 14 November 2016 (UTC)

Ah, well Jytdog, I understand. You mean that during the week your work does not leave you free time.

"A laundrylist is still not helpful" but it improves the current one[5] and is correctly adjusted and referenced. This more complete list I propose is preferable to what is already present, which is scarce, not representative and insufficiently referenced.

I agree that you improve the content I add, but remember not to delete information properly referenced and note that you do not control articles WP:OWN. Others may add information.

I'm going to edit.

Best regards. --BallenaBlanca (Talk) 04:18, 15 November 2016 (UTC)

What I was saying is that I did not get to this OVER THE WEEKEND. I am NOT saying that I can only edit on the weekends. I am ALSO saying that the laundry list is NOT HELPFUL. It is clutter and doesn't give useful information. Jytdog (talk) 04:23, 15 November 2016 (UTC)

Ah, ok, now I understand! Jytdog, you do not have to yell at me. Keep calm and be patient, please. Remember that English is not my native language.

You said "i wanted to spend time on this" and "will come back after looking for general sources on anxiety and disease" and you do this edit?? [6] You delete a reference that is true general, delete a lot of revisions and sytematic reviews, and do this...?? Is it a joke...?? Please, remember WP:NPOV and WP:OWN.

You say that the content I added (and you have removed [7] ), which is a list of possible causes or differential diagnosis, "is NOT HELPFUL", "doesn't give useful information". It is not your mission to judge whether the information "is useful or it is not". For whom "is NOT HELPFUL", "doesn't give useful information"? This is an encyclopedia and must include encyclopedic content. This content is in fact enciclopedic, and very useful for physicians and lay people, but possibly not please pharmaceutical companies that manufacture drugs for neuropsychiatric diseases. You have to limit yourself to respecting Wikipedia policies and the time and work of other editors. The content I added is correctly referenced, and meets all Wikipedia policies.

With respect to make a list of possible causes or differential diagnosis, this criteria is is followed in hundreds if not thousands of articles in Wikipedia. There is no reason not to do it here. If you think the list is clutter, you may order it. It is not easy to classify, it could be done in several ways, because some types overlap, nor ordering it, since many valid criteria could be followed.

I will trim and reorder a bit according to the prevalence of the main diseases of each block and trying to also considere the age of onset. I hope it improve but I invite you to check it out, following Wikpedia policies.

Best regards. --BallenaBlanca (Talk) 12:30, 16 November 2016 (UTC)

The Testa paper you seem to be pinning a lot of this on, is about (and says it is about) the "pseudopsychiatric emergencies, which represent up to 10% of all psychiatric disorders". This article is about an emotion, not about a psychiatric disorder or any kind of emergency. Jytdog (talk) 18:28, 16 November 2016 (UTC)

"This article is about an emotion, not about a psychiatric disorder" You can not separate the mind from the body. World Health Organization (2009). Pharmacological Treatment of Mental Disorders in Primary Health Care "Anxiety is a condition characterized by the subjective and physiologic manifestations of fear. In anxiety disorders, individuals experience apprehension, but, in contrast to fear, the source of the danger is unknown. The physiologic manifestations of fear include sweating, shakiness, dizziness, palpitations, mydriasis, tachycardia, tremor, gastrointestinal disturbances, diarrhoea, and urinary urgency and frequency. If anxiety is generalized and persistent over months but not restricted to any particular environmental circumstances, the term generalized anxiety disorder is usually used."

And if you read the information that I prepared Extended content / prevalence, you will see that I have chosen the diseases that may cause symptoms of anxiety (I marked in bold and underlined, to highlight it).

"any kind of emergency" No matter the context: anxiety symptoms are anxiety symptoms, both when attending a person at an emergency department or by a general practitioner at a community health center, or when the person does not seek medical attention; here, in your country, and everywhere worldwide.

Best regards. --BallenaBlanca (Talk) 20:22, 16 November 2016 (UTC)

Yes we can, and we do, separate disorders from moods. That is why we have separate articles. We have the same problem with people trying to add stuff about MDD to the Depression (mood) article. Lots of people make this mistake. Few persist in it as long as you are doing here. Jytdog (talk) 00:41, 17 November 2016 (UTC)

I have clear concepts. We can separate disorders from moods, but we can not separate body and mind, also lots of people make this mistake, but we are not a puzzle nor a mecano: all emotions, all moods, have physical manifestations, which are not necessarily disorders, obviously... In fact, this is reflected in the definition of the disambiguation page [8] and the definition of WHO [[9] The point of the question is precisely to distinguish when they are manifestations of a mood, a mental disorder, an underlying disease or the result of the consumption of a substance.

Best regards. --BallenaBlanca (Talk) 19:17, 17 November 2016 (UTC)

I'll retrieve this content, but I'll word a sentence a bit, and replace a ref: [10]

Note that after my edits, Doc James, who is a ER doc, reviewed and maintained the content and references [11] We are two editors who agree. Jytdog, please, remember again WP:OWN.

This reference I have used [12], aprobed by Doc James and I to use on this page, covers both "acute psychic manifestations" (see definitions of psychic [13]) and "mimicking specific psychiatric disorders" (see the abstract). Anxiety symptoms are included in the first case, which are by definition limited in time, derived from reaction to a situation and if intense the person may want to go to an emergency service (acute psychic manifestations or subjective and physiologic manifestations of fear); and anxiety disorders, in which anxiety becomes pathological and maintained over the time, are included in the second group (specific psychiatric disorders). Yes, this article refers to "pseudo-psychiatric" because it speaks about the confusion of symptoms of anxiety, symptoms of anxiety disorders or of other psychiatric disorders, with the symptoms of certain organic diseases. No matter the title of the article, what matters is the content. And I have just listed those diseases mentioned in the article wich may present anxiety symptoms, and trimed those related with anxiety disorders. I explained and documented above.

Jytdog seems to be reverting with preconceived ideas and without reading the arguments nor the data I'm spending time locating and presenting here, at least on a part of the occasions. Let's look for example at the times of these edits:

• Talk: Anxiety

06:26, 12 November 2016‎ BallenaBlanca (talk | contribs)‎ . . (22,077 bytes) (+13,315)‎ . . (Recent reversion not justified)

• Anxiety

06:26, 12 November 2016‎ BallenaBlanca (talk | contribs)‎ . . (47,162 bytes) (+1,433)‎ . . (Undid revision 748846630 by Jytdog (talk) See talk page https://en.wikipedia.org/w/index.php?title=Talk:Anxiety&diff=749068967&oldid=744640978)

06:27, 12 November 2016‎ Jytdog (talk | contribs)‎ . . (45,729 bytes) (-1,433)‎ . . (Undid revision 749069011 by BallenaBlanca (talk) yes, do see the talk page)

My message at talk page was long, detailed, including also a compressed table which needs to pick and expand for showing, and 17 references. Jytdog, in one minute, read my edit in Anxiety [14], read the talk page and reviewed the 17 references,[15], and returned to Anxiety, wrote this edit summary (yes, do see the talk page), and reverted my edit.[16] Can someone really do all this in one minute...? That is the interest and respect Jytodg seems to show for my work.

Also, I think that Jytdog should avoid being so disrespectful and contemptuous [17] (I think the word "gobbledegook" is a derogatory term, correct me if I'm wrong). This content was also approved by Doc James, who did not modify nor deleted it after reviewing my edits [18] because is a correct adaptation of the sources (remember that it is necessary to paraphrase and not copy literally).

And the title of this ref [19] removed by Jytdog at this edit [20] is in fact "The association between Diabetes mellitus and Depression" but is not just "focused on depression in diabetes", because it includes data to the prevalence of anxiety symptoms (40%), citing this systematic review PMID 12479986 (everybody can read it to check because is free access), wich concludes "The subsyndromal presentation of anxiety disorder not otherwise specified and of elevated anxiety symptoms were found in 27% and 40%, respectively, of patients with diabetes.", so there is no reason to remove it. However, I have no problem in replacing it with the systematic review.

Best regards. --BallenaBlanca (Talk) 11:14, 18 November 2016 (UTC)

This "Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases." looks like a good reference. Table two has a nice list of the psychiatric symptoms that each medical disorder can cause. Anxiety is both a symptom of some psychiatric disorders and a symptoms of some medical disorders. Psychiatric disorders include a clause that medical disorders have been first ruled out. I think these details both belong here in the "cause" section of anxiety and in the differential diagnosis section of "anxiety disorder" Doc James (talk · contribs · email) 19:20, 18 November 2016 (UTC)

Bellena the reference on Diabetes and depression is focused on depression. there is a couple of passing mention of anxiety. Do not misrepresent sources. This discussion is difficult enough as it is Jytdog (talk) 19:50, 18 November 2016 (UTC)

It's a good observation, Jytdog, do not misrepresent sources. (This does not matter, but it's Ballena and not Bellena).

I agree, Doc James. The page of Anxiety disorders does not have a specific differential diagnosis section. Do you propose to create it, or to include this information within the diagnostic section?

Best regards. --BallenaBlanca (Talk) 01:44, 20 November 2016 (UTC)

Yes a differential diagnosis section here would be good IMO. Doc James (talk · contribs · email) 01:48, 20 November 2016 (UTC)

All right, Doc James, I agree. And I have been browsing other related pages, in which we should also make it clear, or "more clear", what you say: "Psychiatric disorders include a clause that medical disorders have been first ruled out. This "Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases." looks like a good reference." I'll get on with it when I have time and review it together.

Best regards. --BallenaBlanca (Talk) 19:37, 20 November 2016 (UTC)

216.243.12.138

User;216.243.12.138 the refs you are using are not OK per WP:MEDRS and you are removing content that is sourced per MEDRS. Please explain what your goal is here. Thanks. Jytdog (talk) 21:47, 16 December 2016 (UTC)

Repressed emotion type of anxiety

It seems to me that at least one type of anxiety is missing in the "Types" section: the kind of anxiety one fells when repressing an unpleasant emotion (generally sadness or anger). This anxiety is actually mentioned in the "Causes->Psychological" subsection, but it does not match any of the proposed types of anxiety above.