Well-being and life satisfaction in generalized anxiety disorder: comparison to major depressive disorder in a community sample.
BACKGROUND
In most settings, generalized anxiety disorder (GAD) is highly comorbid with major depressive disorder (MDD). This raises uncertainty about the clinical relevance of GAD as a distinct diagnostic entity. The demonstration of functional impairment attached to GAD, independent of that attributable to MDD, would support the importance of GAD as a separate diagnostic category.


METHODS
The Ontario Health Survey Mental Health Supplement, a survey of more than 8000 residents aged 15-64 of the Canadian province of Ontario, used the University of Michigan Composite International Interview Schedule (also used in the US National Comorbidity Survey) to assign DSM-III-R diagnoses. Several indicators of disability and quality of life were included. Our analytic strategy was to compare these indices in persons with and without GAD, stratified by MDD comorbidity, and adjusting for the effects of relevant sociodemographic factors (e.g., social class, age, gender) and dysthymia. Odds ratios (ORs) are reported; SUDAAN was used to adjust for the sampling framework.


RESULTS
GAD was highly comorbid with MDD on both a lifetime and past-year basis. Both past-year and lifetime MDD and GAD were associated with an increased likelihood of low overall perceived well-being. Both lifetime MDD and GAD were associated with dissatisfaction in one's main activity and with family relationships.


CONCLUSIONS
Other comorbid Axis I or II conditions might be confounders with impairment; a lower rate of GAD than in some prior surveys bears consideration.


CONCLUSIONS
These observations confirm that GAD is associated with an increased likelihood of poor global well-being and life satisfaction, beyond that associated with MDD. Given the chronicity of GAD relative to the more often episodic course of MDD, the long-term functional benefits of treating GAD may be substantial.
Stein
Murray B
MB
Anxiety and Traumatic Stress Disorders Program Department of Psychiatry (0985), University of California San Diego, La Jolla, CA 92093-0985, USA. mstein@ucsd.edu
Heimberg
Richard G
RG
D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life