[Prevalence and correlates of generalized anxiety disorders in primary care]

Abstract

Aim: The investigators evaluated the (target-day) point prevalence and correlates of generalized anxiety and depression in German primary care practices.

Method: The study used a representative national sample of more than 500 primary care practices. On a target day, all primary care patients were examined by questionnaires (GAS-Q and DSQ).

Results: Conservatively estimated, 5.3% of all primary care patients met criteria for generalized anxiety disorder (GAD). Similar prevalence estimations were found for Major Depression. Only 30% of all GAD patients met criteria for depression cross-sectionally. Patients with GAD (whether comorbid with depression or not) were more frequently female, reported an onset of GAD mostly between ages of 25 and 45 years, had increased rates of disability and impairment in major social roles and high utilization rates of all health care resources. They also revealed a predominantly chronic course of illness over a period of several years and an increased suicide rate. The presence of physical illness increased rates of handicap/impairment days in the past month. Associated negative outcomes were found to be similar to those observed in depressive disorders. Patients with GAD reported significantly more frequently sleep, anxiety and depressive problems as primary reasons for contact.

Conclusion: The GAD-P study highlights the significance of GAD in primary care as a condition that occurs at about the same frequency as major depression. Further, the relatively high proportion of pure GAD suggests that the frequency of depression-comorbidity of GAD has previously been overestimated.