Patterns and Correlates of Generalized Anxiety Disorder in Community Samples

Background: Although generalized anxiety disorder (GAD) is at least twice as prevalent as panic disorder and is among the commonly occurring mental disorders, changing diagnostic criteria havehampered the cumulation of data on patterns and correlates. Method: A computer literature search was carried out for the terms generalized anxiety disorder and GAD in the MEDLINE and PsycLIT databases. Reports published in English since 1995 were reviewed to determine patterns and correlates ofGAD in the general population. Results: The literature shows clearly that GAD is a commonly occurring disorder associated with serious impairment. Although the high comorbidities of GAD with otherdisorders in clinical samples led to speculation that the impairments associated with GAD were dueto comorbid conditions, several recent studies show that pure GAD is associated with serious impairments.Considerable uncertainty remains regarding appropriate diagnostic criteria. The requirementsthat the anxiety be excessive and persist for 6 months are the subject of the most controversy. Recentlyreported community epidemiologic data show that generalized anxiety syndromes that persist forshorter time periods and that are not excessive in relation to objective stressors are as seriously impairingas syndromes that meet full criteria for GAD. It is less clear whether currently available treatmentsare as useful in resolving episodes of generalized anxiety that lie outside the boundaries of currentICD and DSM criteria. Conclusion: GAD is a commonly occurring mental disorder that canseriously impair functioning. Coordinated community epidemiologic studies and treatment effectivenessstudies are needed to resolve remaining uncertainties regarding the diagnostic boundaries ofGAD.