Implications of modifying the duration requirement of generalized anxiety disorder in developed and developing countries

Lee, S.; Tsang, Adley; Ruscio, Ayelet Meron; Haro, Josep María; Stein, Dan J.; Alonso, Jordi; Angermeyer, M. C.; Bromet, Evelyn J.; Demyttenaere, Koen; Girolamo, Giovanni de; Graaf, Ron de; Gureje, Oye; Iwata, Noboru; Karam, Elie G.; Jp, Lépine; Levinson, Daphna; Me, Medina-Mora; Browne, Mark A. Oakley; Posada‐Villa, José; Kessler, Ronald C.

doi:10.1017/s0033291708004807

Cited by 46 publications

(52 citation statements)

References 31 publications

(60 reference statements)

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“…(WMHS; see also NCS-R). [78][79][80] When the duration was reduced to 3 months in the second Australian NSMHWB (which used the same assessment instrument as the WMHS) 13% more patients reported seeking treatment because of their anxiety and worry as compared with the 29% increase in the general population prevalence across the WMHS. [81] A number of studies have shown that a lower duration threshold (e.g., 1 month, 3 months) would identify respondents with similar symptom severity and clinical impairment to the current 6-month threshold (WHO Psychological Problems in Primary Care; NCS-R; Zurich Cohort Study).…”

Section: Dsm-v Options For ''A Number Of Events or Activities''mentioning

confidence: 99%

“…[79,82,83] Requiring a longer duration requirement (e.g., 12 months), however, would identify respondents with more severe and impairing symptoms than are found in DSM-IV GAD (WMHS). [78] Moreover, variations in the duration threshold would not substantially influence the type of person identified in DSM-V in terms of demographics (ECA; NCS-R; Zurich Cohort Study); [79,83,84] age of onset (WMHS); [78] familial risk of GAD (Virginia Twin Registry; NCS-R; EDSP); [77,85,86] or comorbidity profiles (ECA; Zurich Cohort Study; WMHS; EDSP). [62,78,83,84] Symptom endorsement profiles are also similar between DSM-IV-defined GAD and GAD of 3-5 month duration (German National Health Interview and Examination Survey).…”

Section: Dsm-v Options For ''A Number Of Events or Activities''mentioning

confidence: 99%

“…[78] Moreover, variations in the duration threshold would not substantially influence the type of person identified in DSM-V in terms of demographics (ECA; NCS-R; Zurich Cohort Study); [79,83,84] age of onset (WMHS); [78] familial risk of GAD (Virginia Twin Registry; NCS-R; EDSP); [77,85,86] or comorbidity profiles (ECA; Zurich Cohort Study; WMHS; EDSP). [62,78,83,84] Symptom endorsement profiles are also similar between DSM-IV-defined GAD and GAD of 3-5 month duration (German National Health Interview and Examination Survey). [87] The aforementioned data suggest that the DSM-V classification would continue to identify a clinically significant generalized anxiety syndrome even if the duration threshold were lowered.…”

Section: Dsm-v Options For ''A Number Of Events or Activities''mentioning

confidence: 99%

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Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V

Andrews¹,

Hobbs²,

Borkovec³

et al. 2010

Depress. Anxiety

226

187

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Background: Generalized anxiety disorder (GAD) has undergone a series of substantial classificatory changes since its first inclusion in DSM-III. The majority of these revisions have been in response to its poor inter-rater reliability and concerns that it may lack diagnostic validity. This article provides options for the revision of the DSM-IV GAD criteria for DSM-V. Method: First, searches were conducted to identify the evidence that previous DSM Work Groups relied upon when revising the DSM-III-R GAD and the overanxious disorder classifications. Second, the literature pertaining to the DSM-IV criteria for GAD was examined. Conclusions: The review presents a number of options to be considered for DSM-V. One option is for GAD to be re-labeled in DSM-V as generalized worry disorder. This would reflect its hallmark feature. Proposed revisions would result in a disorder that is characterized by excessive anxiety and worry generalized to a number of events or activities for 3 months or more. Worry acts as a cognitive coping strategy that manifests in avoidant behaviors. The reliability and validity of the proposed changes could be investigated in DSM-V validity tests and field trials. Depression and Anxiety 27:134-147, 2010.

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Section: Dsm-v Options For ''A Number Of Events or Activities''mentioning

confidence: 99%

Section: Dsm-v Options For ''A Number Of Events or Activities''mentioning

confidence: 99%

Section: Dsm-v Options For ''A Number Of Events or Activities''mentioning

confidence: 99%

See 1 more Smart Citation

Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V

Andrews¹,

Hobbs²,

Borkovec³

et al. 2010

Depress. Anxiety

226

187

View full text Add to dashboard Cite

show abstract

“…Similarly, other studies elsewhere (Behar et al, 2005;Hale et al, 2006;Sugiura, 2007;Cassidy et al, 2009;Tan et al, 2010) have also supported the roles of cognitive and social factors in the development and maintenance of GAD. The prevalence of GAD symptoms among the participants was higher than the 3.0% annual prevalence rate of GAD in the general population in low income countries (Lee et al (2009).…”

Section: Discussionmentioning

confidence: 57%

“…It is characterized by chronic worry (Comer & Kendall, 2004) and is twice common in women than in men (Tyrer & Baldwin, 2006). The prevalence rate in the general population is 3.1 % in United States of America (Kessler et al, 2005), 1.9% in Norway (MunkJorgensen et al, 2006), 4.1% in Belgium (Ansseau et al, 2005) and 3% in low income countries (Lee et al, 2009). Cognitive factors like intolerance of uncertainty (Behar et al, 2005;Sugiura, 2007;Tan et al, 2010) and social factors like parental attachment (Hale et al, 2006;Wood, 2006) are strong predictors of GAD.…”

Section: Introductionmentioning

confidence: 99%

Cognitive and social predictors of generalized anxiety disorder symptoms among fresh undergraduates in Uganda

Umeh

Bangirana

2016

Tanzania J Hlth Res

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Background: Generalized anxiety disorder (GAD) is common. It accounts for about one out of four anxiety related clinic consultations. The prevalence of this common disorder and the associated factors in Ugandan students are unknown. The objectives of this study were to determine the prevalence of GAD symptoms, and to evaluate its association with intolerance of uncertainty and parental attachment among fresh undergraduates in Uganda. Methods: The research utilized a cross-sectional approach. Non-clinical participants from 8 colleges (mean age 21.24; 59.7% males, 40.3% females) completed self-report inventories measuring intolerance of uncertainty, parental attachment and GAD symptoms. Pearson's correlations were run to test relationship between the independent and dependent variables, a stepwise regression analysis was used to identify predictors of GAD, while controlling for age. Results: A total of 401 students were involved in the study. The prevalence of GAD symptoms was 28.9%. There was a significant positive relationship between GAD symptoms and intolerance of uncertainty (r = 0.30, p = 0.001) and with parental attachment (r = 0.21, p = 0.001). Intolerance of uncertainty and parental attachment, predicted GAD symptoms (r = 0.30, 95% CI = 0.30 to 6.16, p = 0.001; r = 0.21, 95% CI = 0.21 to 4.19, p = 0.001, respectively). Conclusion:The present research suggests that GAD symptoms are prevalent among fresh undergraduates and are associated with both intolerances of uncertainty and parental attachment. Psychological interventions for undergraduate students may be needed to target these factors.

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Cross-sectional Comparison of the Epidemiology of DSM-5 Generalized Anxiety Disorder Across the Globe

et al. 2017

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IMPORTANCE Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, and debates persist about the seriousness of this disorder. Few data exist on GAD outside a small number of affluent, industrialized nations. No population-based data exist on GAD as it is currently defined in DSM-5. OBJECTIVE To provide the first epidemiologic data on DSM-5 GAD and explore cross-national differences in its prevalence, course, correlates, and impact. DESIGN, SETTING, AND PARTICIPANTS Data come from the World Health Organization World Mental Health Survey Initiative. Cross-sectional general population surveys were carried out in 26 countries using a consistent research protocol and assessment instrument. A total of 147 261 adults from representative household samples were interviewed face-to-face in the community. The surveys were conducted between 2001 and 2012. Data analysis was performed from July 22, 2015, to December 12, 2016. MAIN OUTCOMES AND MEASURES The Composite International Diagnostic Interview was used to assess GAD along with comorbid disorders, role impairment, and help seeking. RESULTS Respondents were 147 261 adults aged 18 to 99 years. The surveys had a weighted mean response rate of 69.5%. Across surveys, DSM-5 GAD had a combined lifetime prevalence (SE) of 3.7%(0.1%), 12-month prevalence of 1.8%(0.1%), and 30-day prevalence of 0.8%(0). Prevalence estimates varied widely across countries, with lifetime prevalence highest in high-income countries (5.0% [0.1%]), lower in middle-income countries (2.8% [0.1%]), and lowest in low-income countries (1.6% [0.1%]). Generalized anxiety disorder typically begins in adulthood and persists over time, although onset is later and clinical course is more persistent in lower-income countries. Lifetime comorbidity is high (81.9% [0.7%]), particularly with mood (63.0% [0.9%]) and other anxiety (51.7% [0.9%]) disorders. Severe role impairment is common across life domains (50.6% [1.2%]), particularly in high-income countries. Treatment is sought by approximately half of affected individuals (49.2% [1.2%]), especially those with severe role impairment (59.4% [1.8%]) or comorbid disorders (55.8% [1.4%]) and those living in high-income countries (59.0% [1.3%]). CONCLUSIONS AND RELEVANCE The findings of this study show that DSM-5 GAD is more prevalent than DSM-IV GAD and is associated with substantial role impairment. The disorder is especially common and impairing in high-income countries despite a negative association between GAD and socioeconomic status within countries. These results underscore the public health significance of GAD across the globe while uncovering cross-national differences in prevalence, course, and impairment that require further investigation.

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Implications of modifying the duration requirement of generalized anxiety disorder in developed and developing countries

Cited by 46 publications

References 31 publications

Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V

Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V

Cognitive and social predictors of generalized anxiety disorder symptoms among fresh undergraduates in Uganda

Cross-sectional Comparison of the Epidemiology of DSM-5 Generalized Anxiety Disorder Across the Globe

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