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Generalized Anxiety Disorder, Somatization, and Emotional Dysregulation: A Possible Link

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Clinical Cases in Psychiatry: Integrating Translational Neuroscience Approaches

Abstract

In clinical practice, it is quite common to deal with patients who primarily express somatic symptoms. They can be distinctive features of depressive disorders, of anxiety disorders, in particular general anxiety disorder, and, less commonly, of somatic symptom disorders. Nonetheless, in several patients, these three conditions could coexist and delineate a clinical picture driven by emotional dysregulation (ED). ED is an emotional response to external stimuli that is poorly modulated and does not fall within the conventionally accepted range of emotive response, which can be characterized by marked and rapid fluctuation of mood, mood lability, weeping crisis, eating problems, and up to behavior outbursts. In our clinical case, a female patient came to our attention reporting headache, gastrointestinal disturbance, hyporexia, and leg restlessness. The diagnostic approach is pictured, and a correct pharmacological treatment is shown in this chapter.

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Author information

Authors and Affiliations

  1. Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

    Gianluigi Tacchini & Matteo Vismara

Authors
  1. Gianluigi Tacchini
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  2. Matteo Vismara
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Corresponding author

Correspondence to Gianluigi Tacchini .

Editor information

Editors and Affiliations

  1. Department of Neuroscience and Mental Health, IRCCS Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

    Alfredo Carlo Altamura

  2. Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy, IRCCS “E. Medea” Scientific Institute, Bosisio Parini (Lc), Italy

    Paolo Brambilla

Self-Assessment Questionnaire

Self-Assessment Questionnaire

  1. 1.

    Which of the following sentences about the epidemiology of GAD is true?

    1. (A)

      It is more common in female and in the elderly.

    2. (B)

      It is less common in high-income countries.

    3. (C)

      It is associated with smoking.

    4. (D)

      It is a rare disorder, with a prevalence < 1% in the general population.

  2. 2.

    Which of the following diseases is not included in the DSM 5 diagnostic group of “somatic symptom and related disorders”?

    1. (A)

      Somatic symptoms disorder

    2. (B)

      Illness anxiety disorder

    3. (C)

      Body dysmorphic disorder

    4. (D)

      Functional neurological symptom disorder

  3. 3.

    Which is one of the main brain structures implicated in the regulation of emotional response?

    1. (A)

      The prefrontal cortex

    2. (B)

      The basal nuclei

    3. (C)

      The corpus callosum

    4. (D)

      The postcentral gyrus

  4. 4.

    Which is the most common alteration in positron emission tomography study associated with patients affected by depression?

    1. (A)

      Decreased diffuse captation of the tracer

    2. (B)

      Augmented captation of the tracer in the frontal lobe

    3. (C)

      Decreased captation of the tracer in the frontal lobe

    4. (D)

      Decreased captation of the tracer in the limbic system

  5. 5.

    Which could be the best therapeutic approach for this clinical case?

    1. (A)

      Antidepressants

    2. (B)

      Antidepressants + mood stabilizers

    3. (C)

      Antipsychotics

    4. (D)

      Cognitive behavior therapy

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Tacchini, G., Vismara, M. (2019). Generalized Anxiety Disorder, Somatization, and Emotional Dysregulation: A Possible Link. In: Altamura, A., Brambilla, P. (eds) Clinical Cases in Psychiatry: Integrating Translational Neuroscience Approaches. Springer, Cham. https://doi.org/10.1007/978-3-319-91557-9_12

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  • DOI: https://doi.org/10.1007/978-3-319-91557-9_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-91556-2

  • Online ISBN: 978-3-319-91557-9

  • eBook Packages: MedicineMedicine (R0)

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