The Role of Ethnicity in Expression, Prevalence, and Severity of Generalized Anxiety Disorder and their Overlap with Depressive Symptoms: Epidemiological Evidence from a Rapidly Developing Middle Eastern Country

IntroductionQatar is a small but high-income Middle Eastern country with a large influx of migrants each year. However, the impact of changing population structure and urbanization on prevalence of generalized anxiety symptoms remains unexplored to date. Materials & MethodsA total of 2,640 participants interviewed by phone using the Generalized Anxiety Disorder (GAD-7) and the Patient Health Questionnaire (PHQ-2). Bivariate and multinomial logistic regression analyses were conducted to explore the associations of ethnicity (Arab versus Non-Arab) with severity and symptom profile of GAD and overlap with depressive symptoms. ResultsThe point prevalence of mild, moderate, and severe symptoms were 13.4% (95% CI: 11.9 – 15.0), 2.7% (95% CI: 2.0 – 3.5), and 0.9% (95% CI: 0.6– 1.4), respectively. Arab ethnicity was associated with mild GAD (OR=1.78, p=0.009) and moderate-to-severe GAD (OR=2.36, p=0.044). Relative to non-migrants, migrant types were not significantly associated with mild or with moderate-to- severe GAD. Interactions between depressive symptoms and ethnicity were evident and statistically significant for the association with mild GAD versus no GAD (OR=0.34, p=0.003). ConclusionsEthnicity moderated the association of depression symptoms and GAD severity, with potential implications for early screening and community intervention.