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Anxiety Disorder E027

Document
Last amended 
14 November 2016
Current RMA Instruments:
Consolidated RH SOP
102 of 2014 as amended by 99 of 2016
Consolidated BOP SOP
103 of 2014 as amended by 100 of 2016
Changes from previous Instruments:

SOP bulletin 193

ICD Coding:
  • ICD-9-CM Codes: 293.89,300.02,300.00
  • ICD-10-AM Codes: F06.4, F41.1, F41.8, F41.9
Brief dsecription

This is a collection of psychiatric disorders with anxiety as a significant clinical manifestation. It covers endogenous anxiety disorders but not those reactive anxiety type psychiatric disorders such as posttraumatic stress disorder and adjustment disorder with anxious mood and not the specific phobias or panic disorders.

Confirming the diagnosis

A report from a specialist psychiatrist that conforms with the Repatriation Commission Guidelines for Psychiatric Compensation Claims is required for diagnosis.  The diagnosis is made with reference to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

Diagnoses covered by SOP
  • Generalised anxiety disorder
  • Anxiety disorder due to another medical condition
  • Unspecified anxiety disorder
  • Other specified anxiety disorder
  • Substance/medication induced anxiety disorder
Conditions excluded from SOP
  • Acute stress disorder*
  • Adjustment disorder*
  • Obsessive-compulsive disorder#, ICD code 300.3
  • Panic disorder*
  • Phobias#, ICD code 300.2
  • Posttraumatic stress disorder*
  • Symptoms of anxiety not meeting the threshold for a DSM-5 disorder - NIF

* another SOP applies  - the SOP has the same name unless otherwise specified

# Non-SOP condition 

Clinical onset

The clinical onset of an anxiety disorder will be when the required level of symptoms/features necessary to meet the diagnostic criteria were first fulfilled, which may be some time after relevant symptoms first developed - i.e., if initially some anxiety symptoms were present, but they were insufficient to meet the diagnostic criteria (e.g. less than the three of six symptoms required for generalised anxiety disorder were present), then the anxiety disorder had not had its clinical onset at that point.  Where the criteria require a minimum duration of symptoms confirmation of the diagnosis can only occur once that duration requirement has been met, but the clinical onset can then be retrospectively assessed as being at the start of the period from when the required symptoms were first present.

Clinical worsening

Symptoms of generalised anxiety disorder tend to be chronic and to wax and wane over time. Symptoms may fluctuate between meeting diagnostic criteria and being below the threshold for diagnosis.  Rates of full remission are very low.  A range of treatment options are available and the effectiveness of treatment varies between types and between individuals.  For anxiety disorder due to another medical condition the course generally follows the course of the underlying illness.