Psychological Medicine



Original Article

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 1


BRIDGET F. GRANT a1c1, DEBORAH S. HASIN a2, FREDERICK S. STINSON a1, DEBORAH A. DAWSON a1, W. JUNE RUAN a1, RISË B. GOLDSTEIN a1, SHARON M. SMITH a1, TULSHI D. SAHA a1 and BOJI HUANG a1
a1 Laboratory of Epidemiology and Biometry, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
a2 Departments of Epidemiology and Psychiatry, Columbia University and New York State Psychiatric Institute, NY, USA

Article author query
grant bf   [PubMed][Google Scholar] 
hasin ds   [PubMed][Google Scholar] 
stinson fs   [PubMed][Google Scholar] 
dawson da   [PubMed][Google Scholar] 
june ruan w   [PubMed][Google Scholar] 
goldstein rb   [PubMed][Google Scholar] 
smith sm   [PubMed][Google Scholar] 
saha td   [PubMed][Google Scholar] 
huang b   [PubMed][Google Scholar] 

Abstract

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.

(Published Online October 5 2005)


Correspondence:
c1 Laboratory of Epidemiology, Room 3077, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, M.S. 9304, 5635 Fishers Lane, Bethesda, MD 20892-9304, USA. (Email: bgrant@willco.niaaa.nih.gov)


Footnotes

1 The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of any of the sponsoring agencies or the USA government.



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