Functioning and disability levels in primary care out-patients with one or more anxiety disorders
Open Access
- 11 February 2010
- journal article
- research article
- Published by Cambridge University Press (CUP) in Psychological Medicine
- Vol. 40 (12), 2059-2068
- https://doi.org/10.1017/s0033291710000176
Abstract
BackgroundAnxiety disorders are the most prevalent mental health disorders and are associated with substantial disability and reduced well-being. It is unknown whether the relative impact of different anxiety disorders is due to the anxiety disorder itself or to the co-occurrence with other anxiety disorders. This study compared the functional impact of combinations of anxiety disorders in primary care out-patients.MethodA total of 1004 patients with panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD) or post-traumatic stress disorder (PTSD) provided data on their mental and physical functioning, and disability. Multivariate regressions compared functional levels for patients with different numbers and combinations of disorders.ResultsOf the patients, 42% had one anxiety disorder only, 38% two, 16% three and 3% all four. There were few relative differences in functioning among patients with only one anxiety disorder, although those with SAD were most restricted in their work, social and home activities and those with GAD were the least impaired. Functioning levels tended to deteriorate as co-morbidity increased.ConclusionsOf the four anxiety disorders examined, GAD appears to be the least disabling, although they all have more in common than in distinction when it comes to functional impairment. A focus on unique effects of specific anxiety disorders is inadequate, as it fails to address the more pervasive impairment associated with multiple anxiety disorders, which is the modal presentation in primary care.Keywords
This publication has 43 references indexed in Scilit:
- Validation of a brief measure of anxiety-related severity and impairment: The Overall Anxiety Severity and Impairment Scale (OASIS)Journal of Affective Disorders, 2008
- Social anxiety disorderThe Lancet, 2008
- Design of the Coordinated Anxiety Learning and Management (CALM) study: innovations in collaborative care for anxiety disordersGeneral Hospital Psychiatry, 2007
- Quality of life in the anxiety disorders: A meta-analytic reviewClinical Psychology Review, 2007
- Social anxiety in primary care: hidden in plain view?General Hospital Psychiatry, 2005
- Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey ReplicationArchives of General Psychiatry, 2005
- Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey ReplicationArchives of General Psychiatry, 2005
- EQ-SD: a measure of health status from the EuroQol GroupAnnals of Medicine, 2001
- Disability and Quality of Life in Social Phobia: Epidemiologic FindingsAmerican Journal of Psychiatry, 2000
- Social Phobia in General Health Care: An Unrecognised Undertreated Disabling DisorderThe British Journal of Psychiatry, 1996