Muhammed Fatih Tabara, Mustafa Cakar, Sema Baykara, Mehmet Gurkan Gurok, Sevda Korkmaz, Osman Mermi, Mustafa Yavuzkir, Murad Atmaca
Van Medical Journal - 2026;33(2):122-128
Introduction: Generalised anxiety disorder (GAD) is a prevalent condition defined by persistent, irrational, and uncontrollable worries regarding various daily activities. While previous research has identified alterations in atrial electrophysiology in conditions such as panic disorder and obsessive-compulsive disorder, P-wave dispersion (Pd) remains largely unexplored in GAD. This study aimed to evaluate Pd parameters -specifically maximum P-wave duration (Pmax) and minimum P-wave duration (Pmin) -in patients with GAD to identify potential cardiac risks associated with chronic anxiety. Materials and Methods: A case-control study was conducted involving 20 patients diagnosed with GAD via the SCID-5-CV and 20 age- and sex-matched healthy controls. Standard 12-lead surface electrocardiograms (ECGs) were recorded at a paper speed of 50 mm/s. Pmax and Pmin were manually measured by a blinded cardiologist using high-precision callipers, with Pd calculated as the difference between the two values (Pmax -Pmin). Symptom severity was assessed using the Hamilton Anxiety Rating Scale (HARS). Results: Statistical analysis revealed that Pmax and Pmin values were significantly elevated in patients with GAD compared to healthy controls. Notably, the primary outcome measure -mean P-wave dispersion -was significantly higher in the patient cohort (50.74 +/- 6.10 ms) than in the control group (35.32 +/- 3.79). Conclusion: Patients with GAD demonstrate a distinct electrophysiological profile characterised by a global prolongation of atrial conduction parameters and significantly increased P-wave dispersion. These findings suggest that the "mental" worry of GAD carries a measurable "physical" cardiac risk, necessitating closer clinical monitoring of atrial electrophysiology, particularly when prescribing psychotropic medications that may influence cardiac conduction.
