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In this issue of the BJGP , Sherina and colleagues provide us with a reminder that generalised anxiety disorder (GAD) is common among primary care patients.1 GAD is one of the most frequent of all psychiatric disorders seen in primary care — second only to depression — but women are twice as likely as men to have this disorder.2 Compared with other patient groups, patients with GAD have higher rates of medical appointments and clinical investigations.3 GAD therefore incurs a substantial burden not only on patients and their families but also on healthcare resources.Primary care is where most patients with GAD present and receive care. Therefore, GPs have a vital role to play in identifying and managing generalised anxiety, together with its primary cause, among their patients. Recognising and treating patients with GAD in primary care is challenging, which is often due to its complex presentation.GAD can easily be missed due to the wide range of clinical presentations and co-occurrence with other psychiatric disorders, somatic complaints, and physical medical conditions. These coexisting associations are important clinically. Patients who have comorbid anxiety and depressive disorders or medical conditions have an extended clinical course and poorer long-term outcomes than patients with ‘pure’ GAD.To complicate matters further, primary care patients report substantial levels of anxiety that do not always automatically meet diagnostic criteria, but the symptoms result in a substantial degree of suffering and disability. However, it is only recently that evidence-based guidelines have been introduced that are helpful in guiding management and treatment decisions in primary care patients with GAD.A partial update of the National Institute for Health and Clinical …

Generalised anxiety disorder: the importance of life context and social factors