Despite being a global mental health concern that affects an estimated 4% of the world’s population, anxiety disorders are difficult to diagnose and track. Because anxiety may present differently for each patient and often co-occurs with other conditions, prolonged diagnosis may lead to associated delays in treatment and have a negative impact on a patient’s quality of life.
However, recent advancements in digital health can help with the diagnosis and tracking of anxiety symptoms over time. For example, computerized cognitive assessments and standardized behavioural questionnaires, like those offered by Creyos, provide an efficient, convenient, and scientifically validated way to identify and monitor the cognitive symptoms of anxiety. By integrating subjective insights and objective data, these digital tools give healthcare professionals a more complete picture of patient mental health. This combination enables confident diagnosis and patient-centered treatment plans.
Anxiety is a natural human emotion characterized by feelings of worry, nervousness, or unease, usually about an event with an uncertain outcome. But when these feelings become excessive, persistent, and interfere with daily life, they may indicate an anxiety disorder.
According to the World Health Organization, anxiety disorders are the most common mental disorders, affecting millions worldwide. If left undiagnosed and untreated, these conditions can significantly lower a patient’s quality of life, leading to impaired social functioning, occupational difficulties, and a higher risk of developing other mental and physical health issues. Research consistently shows a strong link between chronic anxiety and comorbidities such as depression, substance use disorders, and various physical health problems.
There are many types of anxiety disorders, each with its own characteristics. The most common anxiety disorders are:
Anxiety symptoms can vary widely in severity and presentation, but often include both psychological and physical manifestations. Common anxiety symptoms are:
Treatment and management of anxiety disorders usually involve a combination of approaches. Research shows that cognitive behavioral therapy (CBT) can be a highly effective psychological treatment, helping patients identify and change unhelpful thought patterns and behaviors. Medication, such as antidepressants or anti-anxiety medications, can also help alleviate anxiety symptoms, especially for severe anxiety.
Importantly, healthcare providers should focus on tailoring comprehensive care plans to individual patient needs to achieve the best possible outcome. These plans often include lifestyle adjustments, stress reduction techniques, and ongoing assessment.
The "5 Cs” is a framework from the Positive Youth Development model often used to help patients better understand and manage worry and stress. These 5 Cs are:
This framework can help patients take control of their daily lives and manage their anxiety symptoms through the promotion of self-awareness and resilience.
The "333 Rule for Anxiety" is an informal grounding technique recommended to help patients manage overwhelming anxiety or panic attacks. When anxious feelings arise, a patient can:
Although there is currently no formal research into the effectiveness of the 333 method, this technique may help to interrupt the cycle of anxious thoughts by redirecting attention to the present moment and engaging sensory awareness.
Anxiety disorders can have multiple and complex origins, often involving a combination of biological, psychological, and environmental factors. Research suggests that chemical imbalances in the brain, particularly involving neurotransmitters like serotonin and norepinephrine, may be involved. There is also evidence that anxiety disorders can be genetic or related to environmental factors, including stressful life events, trauma, chronic stress, and early childhood experiences.
The process for diagnosing anxiety has traditionally relied on subjective information that is usually gathered through clinical interviews and standardized questionnaires, such as the Generalized Anxiety Disorder Questionnaire (GAD-7) and the Perceived Stress Scale (PSS).
Designed to assess the severity of anxiety symptoms and perceived stress levels, these questionnaires provide valuable insight into a patient’s self-reported experiences of anxiety. They also align with criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which can help with diagnosing anxiety and guiding treatment plans.
Some of the criteria for diagnosing an anxiety disorder in the DSM-5 include excessive anxiety and worry associated with:
Solely relying on subjective information creates an incomplete picture of a patient’s mental and cognitive health. Patients may underreport or overreport symptoms, and recall bias can affect the accuracy of their responses. Symptoms often overlap between different anxiety disorders and other mental health conditions, such as depression or ADHD, which can further complicate diagnosis and make it difficult to distinguish anxiety from comorbidities.
This is where digital cognitive testing methods can support anxiety diagnosis and treatment. By providing efficient and accurate testing in a digital format, these tools can streamline the administration and scoring of questionnaires, reducing administrative burden and providing immediate insights into patient experiences over time.
While questionnaires can capture a patient's perceived experience of anxiety, cognitive tests examine objective cognitive performance across domains of memory, reasoning, verbal processing, and attention. This helps reveal a more comprehensive picture of how anxiety affects a patient’s daily life and can help guide or inform appropriate interventions.
For example, cognitive testing can help quantify the difficulty concentrating mentioned in the DSM’s definition of anxiety. Anxiety can also impair working memory and attentional control, which can relate to difficulties with focus and concentration. Creyos digital cognitive tests have been used in multiple studies to demonstrate how anxiety disorders can impact one’s cognition. One study on human intelligence found a link between anxiety and cognition, particularly in the short-term memory domain. Another study confirmed the link between short-term memory and anxiety, but interestingly, sleep was not associated with memory, showing that deficits due to anxiety may be different from the effects of fatigue in healthy people.
By measuring performance on objective markers from tests of short-term memory, healthcare providers can gain a deeper understanding of the functional impact of anxiety on an individual's brain health.
Objective data helps to confirm and support a diagnosis, differentiate anxiety from other conditions with similar symptoms, and monitor changes in cognitive performance over time in response to treatment. The ability to capture both subjective and objective data ultimately helps clinicians provide more personalized and effective mental healthcare.
GT Healthcare, a telehealth practice in California, helps patients of all ages identify, understand, and manage various mental health conditions, including anxiety. However, due to limitations with self-report questionnaires and time-consuming administrative processes, the team often struggled to efficiently diagnose and track mental health conditions.
Looking to simplify the assessment process, gain objective insights into patient experiences, and improve overall patient care, GT Healthcare partnered with Creyos. The Creyos platform provided the clinic with a comprehensive suite of cognitive assessments and behavioral health questionnaires that are administered digitally. This allowed the team to combine subjective patient-reported data with objective cognitive performance metrics while reducing administrative costs and integrating seamlessly with its telehealth model.
With the objective data from Creyos Health’s cognitive tasks, GT Healthcare clinicians can now:
This data-driven approach enables GT Healthcare to make faster, well-informed mental health diagnoses, leading to more efficient and effective mental health care for its patients.
[CTA PANEL: Read the full case study to learn more about GT Healthcare’s experience with Creyos Health.]
Anxiety is a complex and nuanced condition that can affect every patient differently. To effectively diagnose and manage anxiety disorders, providers should take a comprehensive approach that looks beyond subjective reporting and pen-and-paper screeners. Clinical interviews and questionnaires are a crucial piece of the puzzle, but integrating cognitive assessments provides a more complete picture of a patient's cognitive health and the functional impact of their anxiety.
By combining both subjective and objective measures of anxiety, clinicians can provide whole-person mental healthcare, enhance the patient experience through efficient and convenient testing, and ultimately improve patient health outcomes. Embracing these advanced digital tools empowers healthcare providers to make more confident diagnoses and deliver personalized, evidence-based care for anxiety.
Reviewed by Mike Battista, Director of Science & Research at Creyos
Mike Battista specializes in brain health, cognition, and neuropsychological testing. He received his PhD in personality and measurement psychology at Western University in 2010 and has been doing fun and useful stuff in the intersection between science and technology ever since.