Correlates of generalized anxiety disorder: independent of co-morbidity with depression: findings from the first Israeli National Health Interview Survey (2003-2004).
BACKGROUND
Generalized anxiety disorder (GAD) is a prevalent psychiatric disorder with chronic symptoms and is commonly comorbid with depression.


OBJECTIVE
To identify correlates of GAD among adults and to describe treatment patterns and functional limitations among individuals with this disorder.


METHODS
Data for 2,082 subjects aged >or=21 years from the first Israeli national health interview survey (INHIS-1) (2003-2004) were analyzed. Information on GAD was collected using the short form of the Composite International Diagnostic Interview. Data were also obtained on socio-demographic, physical health characteristics, history of life threatening events, treatment seeking behaviors, use of medication and functional impairment.


RESULTS
The prevalence of GAD was highest among people aged 40-59 years, in those with asthma, hypertension and in those with osteoporosis. Regular exercise was associated with reduced prevalence for GAD (adjusted OR 0.46, 95% CI 0.22-0.95). The exclusion of individuals with major depression from analysis strengthened the association with age (adjusted OR 5.7, 95% CI 1.7, 19.7), weakened the association between GAD and osteoporosis (adjusted OR 3.4, 95% CI 1.2, 9.8), asthma (adjusted OR 3.4, 95% CI 1.2, 9.5) and regular exercise (adjusted OR 0.47 95% CI 0.2, 1.14). In this sub-sample, hypertension was no longer associated with GAD, and a significant association was found between GAD and past experience of life threatening events (adjusted OR 2.3, 95% CI 1.1-4.9). Psychiatric and psychological consultations were low among people with GAD (11.5% and 26.4% for those without and with comorbid depression, respectively), concurrent with a high degree of functional limitation.


CONCLUSIONS
Middle age, history of traumatic life events, and certain chronic medical diseases (e.g., asthma and osteoporosis) are important risk factors for GAD. They could be used to help identify and treat people with GAD.
Muhsen
Khitam
K
Israel Center for Disease Control, Ministry of Health, Gertner Institute, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Israel. khitam.m@icdc.health.gov.il
Lipsitz
Joshua
J
Garty-Sandalon
Noga
N
Gross
Raz
R
Green
Manfred S
MS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D007557:Israel / Q000453:epidemiology; D008016:Life Change Events; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D055815:Young Adult