226 Anxiety Disorders
agnosed separately if the excessive worry h as occurred only during the course of these
conditions.
Comorbidity
Individuals whose presen tation meets criteria for genera lized anxiety disorder are likely
to have met, or currently meet, criteria for other anxiety and unip olar depressive disor-
ders. The neuroticism or emotional liability th at underpins this pattern of comorbidity is
associated with temperamental antecedents and genetic and environmental risk factors
shared between these disorders, although in dependent pathways are also possible. Co-
morbidity with substance use, conduct, psychotic, neurodevelopmental, and neurocogni-
tive disorders is less common.
Substance/Medication-Induced
 Anxiety Disorder
Diagnostic Criteria
A. Panic attacks or anxiety is predominant in the clinical picture.
B. There is evidence from the history, physical examination, or laboratory findings of both
(1) and (2):
1. The symptoms in Criterion A developed during or soon after substance intoxication
or withdrawal or after exposure to a medication.
2. The involved substance/medication is capable of producing the symptoms in Crite-
rion A.
C. The disturbance is not better explained by an anxiety disorder that is not substance/
medication-induced. Such evidence of an independent anxiety disorder could include
the following:
The symptoms precede the onset of the substance/medication use; the symptoms
persist for a substantial period of time (e.g., about 1 month) after the cessation of
acute withdrawal or severe intoxication; or there is other evidence suggesting the
existence of an independent non-substance/medication-induced anxiety disorder
(e.g., a history of recurrent non-substance/medication-related episodes).
D. The disturbance does not occur exclusively during the course of a delirium.