DiscussionBiomedical Sciences: Generalized Anxiety DisorderDC is diagnosed with generalized anxiety disorder (GAD), a common anxiety disorder, with an estimated lifetime prevalence of 5% (using DSM-IV criteria)[1]. It is characterized by persistent and uncontrollable anxiety and worry that the patient usually recognizes as excessive and irrational. It can be a chronic and debilitating condition and worsens the prognosis of other conditions[2]. The exact mechanism of GAD is unclear. Given the high degree of comorbidity of GAD and depression, and the fact that symptoms of both conditions respond to the same treatment, it is possible that the two conditions share a common neurobiological dysfunction[3]. The involvement of the serotonin (5-HT) system is perhaps the most studied mechanism. Serotonergic pathways between the dorsal raphe nucleus and the temporal lobe, hippocampus, and amygdala are thought to play a key role in regulating anxiety and coping with chronic adversity and depression. In patients with GAD, 5-HT levels in the cerebrospinal fluid are reduced compared to control patients, a finding replicated in suicidal individuals. Depletion of 5-HT in the brain during 5-HT depletion studies using tryptophan has been shown to cause relapses in depressed patients treated with selective serotonin reuptake inhibitors (SSRIs), further supporting the role of 5-HT in depression. To date, no similar studies have been conducted for GAD[3]. Neuroimaging findings indicate that overactive brain circuits are present in GAD. It has been hypothesized that hyperactivity in specific areas gives rise to GAD symptoms (e.g., hyperactivity in the basal ganglia and temporal lobes leads to motor tension and autonomic changes, respectively)[3]......half of the article. .....most important points to address[7]. In the case of DC, he possesses a number of epidemiological and clinical risk factors, and in this sense he is at high risk of complete suicide in the next year. Both the Pierce (7/25) and Beck (25/45) scales indicate medium suicidal intent. However, there are some reassuring features in the story: the act was impulsive; DC sought help immediately after the act; and did not take the extra venlafaxine tablets available in his apartment. His interview and mental status examination were also encouraging. There are several measures that could be taken to reduce the risk of suicide, from immediate ones (for example, removing extra venlafaxine tablets from your apartment) to long-term ones (for example, getting a job). Adequate social support must be put in place before returning home, through a combination of IHTT, his father, CPN and OT.