in hypochondriasis ,anxiety may be pervasive ;however, in contrast to generealized anxiety disorder , the symptoms are always intimately connected with one thing,namely the patient's apprehension that she may have an underlying serious disease.
patients dependent on alcohol, sedative-hypnotics,or anxiolytics may repeatedly find themselves in the mindst of withdrawal symptoms characterized by anxiety and autonomic symptom. should their substance use be secret,a diagnosis of generalized anxiety disorder might be considered. one clue would be a marked fluctuation in symptoms occurring over hours. such a course is not seen in generalized anxiety disorder but is quite typicalof an intoxication fading rapidly into withdrawal.
a variety of drugs if taken chronically may produce a constant set of side effects that may mimic generalized anxiety disorder. these include caffeine , sympathomimetics , such as desipramine , bupropion , and the SSRIs. antipsychotic-induced akathisia may also at times cause some diagnotic uncertainty