scholarly journals Prevalence, correlates, co-morbidity, and comparative disability of DSM-IV generalized anxiety disorder in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions

2005 ◽  
Vol 35 (12) ◽  
pp. 1747-1759 ◽  
Author(s):  
BRIDGET F. GRANT ◽  
DEBORAH S. HASIN ◽  
FREDERICK S. STINSON ◽  
DEBORAH A. DAWSON ◽  
W. JUNE RUAN ◽  
...  
Keyword(s):  
Substance Use ◽  
Anxiety Disorder ◽  
Mood Disorder ◽  
Personality Disorders ◽  
Generalized Anxiety Disorder ◽  
Generalized Anxiety ◽  
Epidemiologic Survey ◽  
Co Morbidity ◽  
Axis I ◽  
Dsm Iv

Background. This study addressed the prevalences, correlates, co-morbidity and disability of DSM-IV generalized anxiety disorder (GAD) and other psychiatric disorders in a large national survey of the general population, the National Institute on Alcohol Abuse and Alcoholism's (NIAAA) National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The study presents nationally representative data, for the first time, on prevalence, correlates, co-morbidity, and comparative disability of DSM-IV GAD.Method. Data are taken from a large (n=43093) representative sample of the adult USA population.Results. Prevalences of 12-month and lifetime GAD were 2·1% and 4·1%. Being female, middle-aged, widowed/separated/divorced, and low income increased risk, while being Asian, Hispanic, or Black decreased risk. GAD was highly co-morbid with substance use, and other anxiety, mood, and personality disorders. Co-morbidity in GAD was not substantially greater than for most other Axis I and II disorders. Disability and impairment in pure GAD were equivalent to pure mood disorders, but significantly greater than in pure substance use, and other anxiety and personality disorders. Individuals co-morbid for GAD and each mood disorder were more disabled than those with pure forms of GAD or each mood disorder. When co-morbid with GAD, nicotine dependence and other anxiety and personality disorders were not associated with increased disability over that associated with pure GAD, but GAD did show increased disability over that due to each of these disorders in pure form.Conclusions. Associations between GAD and Axis I and II disorders were strong and significant, with variation among specific disorders. Results strongly support GAD as an independent disorder with significant impairment and disability.

scholarly journals The efficacy of antidepressants for generalized anxiety disorder: a systematic review and meta-analysis

2005 ◽  
Vol 27 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Ricardo Schmitt ◽  
Fernando Kratz Gazalle ◽  
Maurício Silva de Lima ◽  
Ângelo Cunha ◽  
Juliano Souza ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Generalized Anxiety ◽  
Number Needed To Treat ◽  
Relative Risks ◽  
Co Morbidity ◽  
Axis I ◽  
Calculated Number

OBJECTIVE: To investigate the efficacy and acceptability of antidepressants in the treatment of generalized anxiety disorder. METHODS: All randomized controlled trials assessing the use of antidepressants in generalized anxiety disorder up to may 2002 were included. Non randomized trials and those that included patients with both generalized anxiety disorder and another Axis I co-morbidity were excluded. Relative risks, weighted mean difference and number needed to treat were estimated. People who died or dropped out were regarded as having had no improvement. RESULTS: Antidepressants (imipramine, venlafaxine and paroxetine) were found to be superior to placebo in treating generalized anxiety disorder. The calculated number needed to treat for antidepressants in generalized anxiety disorder was 5.15. Dropout rates did not differ between antidepressants and placebo. CONCLUSION: The available evidence suggests that antidepressants would probably be a reasonable treatment for generalized anxiety disorder patients in the clinical context.

Generalized anxiety disorder and clinical worry episodes in young women

2002 ◽  
Vol 32 (7) ◽  
pp. 1227-1237 ◽  
Author(s):  
J. HOYER ◽  
E. S. BECKER ◽  
J. MARGRAF
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Young Women ◽  
Psychosocial Functioning ◽  
Predictive Accuracy ◽  
Community Sample ◽  
Epidemiological Data ◽  
Generalized Anxiety ◽  
Co Morbidity ◽  
Dsm Iv

Background. This article presents epidemiological data on the prevalence of DSM-IV generalized anxiety disorder (GAD) and sub-threshold GAD (fulfilling three out of four GAD criteria) in young women together with data on co-morbidity and psychosocial functioning. The prevalence of clinically relevant worry and its predictive validity for the diagnosis of GAD were also examined.Method. Young women (N = 2064), aged between 18 and 25, from a representative German community sample were diagnosed with a structured clinical interview (ADIS-L, German research version). An additional interview questioned all the participants about the frequency/intensity and uncontrollability of diverse worry topics.Results. Thirty-seven participants (1.8%) fulfilled the criteria of current GAD (1 week point prevalence) and 56 received a lifetime diagnosis (2.7%); a further 50 participants (2.3%) were diagnosed with sub-threshold GAD. Co-morbidity between GAD and other disorders was high for current (68%) and lifetime GAD (91%). GAD, as well as sub-threshold GAD, showed clearly reduced levels of psychosocial functioning. Whereas worries of low intensity and high controllability were ubiquitous in all subsamples, clinically defined worrying was rarely present in healthy subjects (0.89%) and of adequate predictive accuracy for GAD.Conclusions. Full GAD and sub-threshold GAD were moderately frequent in young women. Although DSM-IV worry criteria proved to be highly useful, the strictness of the complete GAD-criteria should not lead to absence of attention from subclinical generalized anxiety states in research and practice.

scholarly journals Should excessive worry be required for a diagnosis of generalized anxiety disorder? Results from the US National Comorbidity Survey Replication

2005 ◽  
Vol 35 (12) ◽  
pp. 1761-1772 ◽  
Author(s):  
AYELET MERON RUSCIO ◽  
MICHAEL LANE ◽  
PETER ROY-BYRNE ◽  
PAUL E. STANG ◽  
DAN J. STEIN ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Large Scale ◽  
Familial Aggregation ◽  
Generalized Anxiety ◽  
National Comorbidity Survey Replication ◽  
National Comorbidity Survey ◽  
Co Morbidity ◽  
The Us ◽  
Dsm Iv

Background. Excessive worry is required by DSM-IV, but not ICD-10, for a diagnosis of generalized anxiety disorder (GAD). No large-scale epidemiological study has ever examined the implications of this requirement for estimates of prevalence, severity, or correlates of GAD.Method. Data were analyzed from the US National Comorbidity Survey Replication, a nationally representative, face-to-face survey of adults in the USA household population that was fielded in 2001–2003. DSM-IV GAD was assessed with Version 3.0 of the WHO Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-IV criteria for GAD were compared with respondents who met full GAD criteria as well as with other survey respondents to consider the implications of removing the excessiveness requirement.Results. The estimated lifetime prevalence of GAD increases by ~40% when the excessiveness requirement is removed. Excessive GAD begins earlier in life, has a more chronic course, and is associated with greater symptom severity and psychiatric co-morbidity than non-excessive GAD. However, non-excessive cases nonetheless evidence substantial persistence and impairment of GAD, high rates of treatment-seeking, and significantly elevated co-morbidity compared with respondents without GAD. Non-excessive cases also have sociodemographic characteristics and familial aggregation of GAD comparable to excessive cases.Conclusions. Individuals who meet all criteria for GAD other than excessiveness have a somewhat milder presentation than those with excessive worry, yet resemble excessive worriers in a number of important ways. These findings challenge the validity of the excessiveness requirement and highlight the need for further research into the optimal definition of GAD.

DSM-IV generalized anxiety disorder in the Australian National Survey of Mental Health and Well-Being

2002 ◽  
Vol 32 (4) ◽  
pp. 649-659 ◽  
Author(s):  
C. HUNT ◽  
C. ISSAKIDIS ◽  
G. ANDREWS
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
National Survey ◽  
Population Data ◽  
Well Being ◽  
Generalized Anxiety ◽  
Co Morbidity ◽  
Dsm Iv ◽  
Health And Well Being

Background. This paper reports population data on DSM-IV generalized anxiety disorder from the Australian National Survey of Mental Health and Well-Being.Methods. The data were obtained from a nationwide household survey of adults using a stratified multi-stage sampling process. A response rate of 78·1% resulted in 10641 persons being interviewed. Diagnoses were made using the Composite International Diagnostic Interview. The interview was computerized and conducted by trained lay interviewers.Results. Prevalence in the total sample was 2·8% for 1-month GAD and 3·6% for 12-month GAD. Persons over 55 years of age were less likely to have GAD than those in the younger age groups. Logistic regression analysis also showed that a diagnosis of GAD was significantly associated with being of younger to middle age, being separated divorced or widowed, not having tertiary qualifications or being unemployed. Co-morbidity with another affective, anxiety, substance use or personality disorders was common, affecting 68% of the sample with 1-month DSM-IV GAD. GAD was associated with significant disablement, and 57% of the sample with DSM-IV GAD had consulted a health professional for a mental health problem in the prior 12 months.Conclusions. The survey provides population data on DSM-IV GAD and its correlates. GAD is a common disorder that is accompanied by significant morbidity and high rates of co-morbidity with affective and anxiety disorders, and is associated with marital status, education, employment status, but not sex. Changes to DSM-IV diagnostic criteria did not appear to affect the prevalence rate compared to previous population surveys.

scholarly journals Varying temporal criteria for generalized anxiety disorder: prevalence and clinical characteristics in a young age cohort

2006 ◽  
Vol 36 (9) ◽  
pp. 1283-1292 ◽  
Author(s):  
JULES ANGST ◽  
ALEX GAMMA ◽  
O. JOSEPH BIENVENU ◽  
WILLIAM W. EATON ◽  
VLADETA AJDACIC ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Suicide Attempts ◽  
Social Impairment ◽  
Generalized Anxiety ◽  
Co Morbidity ◽  
Dsm Iv ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Duration Criterion

Background. This study questions the 6-month duration criterion for generalized anxiety disorder (GAD) used in DSM-III-R and DSM-IV.Method. In adults from age 20/21 to 40/41 in the prospective Zurich Cohort Study, four groups of generalized anxiety syndromes defined by varying duration (2 weeks, 1 month, 3 months and 6 months) were compared.Results. Applying DSM-III (1979–1999) and DSM-III-R (1986–1999) criteria, there were no significant differences between the four groups in terms of family history of anxiety, work impairment, distress, treatment rates or co-morbidity with major depressive episodes (MDEs), bipolar disorder or suicide attempts. Only social impairment related to the length of episodes. The 6-month criterion of DSM-III-R and DSM-IV GAD would preclude this diagnosis in about half of the subjects treated for generalized anxiety syndromes.Conclusions. In this epidemiological sample, the 6-month duration criterion for GAD could not be confirmed as clinically meaningful. GAD syndromes of varying duration form a continuum with comparable clinical relevance.

scholarly journals Thought disorder in the meta-structure of psychopathology

2012 ◽  
Vol 43 (8) ◽  
pp. 1673-1683 ◽  
Author(s):  
K. M. Keyes ◽  
N. R. Eaton ◽  
R. F. Krueger ◽  
A. E. Skodol ◽  
M. M. Wall ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
General Population ◽  
Personality Disorders ◽  
Thought Disorder ◽  
Patient Treatment ◽  
Treatment Needs ◽  
Co Morbidity ◽  
The Us ◽  
Axis I ◽  
Dsm Iv

BackgroundDimensional models of co-morbidity have the potential to improve the conceptualization of mental disorders in research and clinical work, yet little is known about how relatively uncommon disorders may fit with more common disorders. The present study estimated the meta-structure of psychopathology in the US general population focusing on the placement of five under-studied disorders sharing features of thought disorder: paranoid, schizoid, avoidant and schizotypal personality disorders, and manic episodes as well as bipolar disorder.MethodData were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a face-to-face interview of 34 653 non-institutionalized adults in the US general population. The meta-structure of 16 DSM-IV Axis I and Axis II psychiatric disorders, as assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV version (AUDADIS-IV), was examined using exploratory and confirmatory factor analysis.ResultsWe document an empirically derived thought disorder factor that is a subdomain of the internalizing dimension, characterized by schizoid, paranoid, schizotypal and avoidant personality disorders as well as manic episodes. Manic episodes exhibit notable associations with both the distress subdomain of the internalizing dimension as well as the thought disorder subdomain. The structure was replicated for bipolar disorder (I or II) in place of manic episodes.ConclusionsAs our understanding of psychopathological meta-structure expands, incorporation of disorders characterized by detachment and psychoticism grows increasingly important. Disorders characterized by detachment and psychoticism may be well conceptualized, organized and measured as a subdimension of the internalizing spectrum of disorders. Manic episodes and bipolar disorder exhibit substantial co-morbidity across both distress and thought disorder domains of the internalizing dimension. Clinically, these results underscore the potential utility of conceptualizing patient treatment needs using an approach targeting psychopathological systems underlying meta-structural classification rubrics.

Diagnostic efficiency of symptoms in the diagnosis of DSM-IV: generalized anxiety disorder in youth

2002 ◽  
Vol 43 (7) ◽  
pp. 959-967 ◽  
Author(s):  
Armando A. Pina ◽  
Wendy K. Silverman ◽  
Candice A. Alfano ◽  
Lissette M. Saavedra
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Generalized Anxiety ◽  
Diagnostic Efficiency ◽  
Dsm Iv

scholarly journals Prevalence and impact of generalized anxiety disorder and major depression in primary care in Belgium and Luxemburg: the GADIS study

2005 ◽  
Vol 20 (3) ◽  
pp. 229-235 ◽  
Author(s):  
Marc Ansseau ◽  
Benjamin Fischler ◽  
Michel Dierick ◽  
Annick Mignon ◽  
Sophie Leyman
Keyword(s):  
Primary Care ◽  
Anxiety Disorder ◽  
Major Depression ◽  
Generalized Anxiety Disorder ◽  
Large Scale ◽  
Screening Program ◽  
Generalized Anxiety ◽  
French Speaking ◽  
Dsm Iv ◽  
Large Scale Screening

AbstractPurposeGADIS aims at determining the prevalence of generalized anxiety disorder (GAD) and major depression (MD) in primary care and their impact on the patient’s functioning in Belgium and Luxemburg.MethodsA large scale screening program was conducted at the consultation of general practitioners to detect patients with GAD and MD according to DSM-IV criteria. We collected additional data regarding the use of hypnotic, tranquilizer, antidepressant and analgesic medications. Impact on the patient was assessed with the Sheehan disability scale.ResultsThree hundred GP’s in Belgium and Luxemburg were asked to screen 50 consecutive patients. Of the 13,677 analyzed patients, 8.3% were diagnosed to have GAD and 6.3% MD. Comorbidity was observed in 4.2% of patients. The prevalence was much higher in the French-speaking part of Belgium. GAD and MD were associated with impairment in social, familial and professional functioning. Only a minority of patients with GAD and/or MD was treated with an antidepressant and almost half of subjects with GAD and/or MD were treated with a tranquilizer.ConclusionsPrevalence rates of GAD and MD in primary care in Belgium are comparable to other countries. GAD and MD are disabling conditions. Antidepressants are still used only in a minority of subjects with GAD and/or MD in primary care in Belgium and Luxemburg. The prevalence of GAD and MD appears to be much higher in French-speaking parts of Belgium.

The effects of co-morbidity on the onset and persistence of generalized anxiety disorder in the ICPE surveys

2002 ◽  
Vol 32 (7) ◽  
pp. 1213-1225 ◽  
Author(s):  
R. C. KESSLER ◽  
L. H. ANDRADE ◽  
R. V. BIJL ◽  
D. R. OFFORD ◽  
O. V. DEMLER ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Composite International Diagnostic Interview ◽  
The United States ◽  
Elevated Risk ◽  
World Health ◽  
Generalized Anxiety ◽  
Co Morbidity ◽  
First Onset ◽  
History Of

Background. Although it is well known that generalized anxiety disorder (GAD) is highly co-morbid with other mental disorders, little is known about the extent to which earlier disorders predict the subsequent first onset and persistence of GAD. These associations are examined in the current report using data from four community surveys in the World Health Organization (WHO) International Consortium in Psychiatric Epidemiology (ICPE).Method. The surveys come from Brazil, Canada, the Netherlands and the United States. The Composite International Diagnostic Interview (CIDI) was used to assess DSM-III-R anxiety, mood and substance use disorders in these surveys. Discrete-time survival analysis was used to examine the associations of retrospectively reported earlier disorders with first onset of GAD. Logistic regression analysis was used to examine the associations of the disorders with persistence of GAD.Results. Six disorders predict first onset of GAD in all four surveys: agoraphobia, panic disorder, simple phobia, dysthymia, major depression and mania. With the exception of simple phobia, only respondents with active disorders have elevated risk of GAD. In the case of simple phobia, in comparison, respondents with a history of remitted disorder also have consistently elevated risk of GAD. Simple phobia is also the only disorder that predicts the persistence of GAD.Conclusions. The causal processes linking temporally primary disorders to onset of GAD are likely to be state-dependent. History of simple phobia might be a GAD risk marker. Further research is needed to explore the mechanisms involved in the relationship between simple phobia and subsequent GAD.

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