title: Functional impairment related to painful physical symptoms in patients with generalized anxiety disorder with or without comorbid major depressive disorder: post hoc analysis of a cross-sectional study.
abstract: BACKGROUND
  Generalized anxiety disorder (GAD) is the most frequent anxiety disorder in primary care patients. It is known that painful physical symptoms (PPS) are associated with GAD, regardless the presence of comorbid major depressive disorder (MDD). However the specific role of such symptoms in patients' functional impairment is not well understood. The objective of the present study is to assess functional impairment related to the presence of PPS in patients with GAD.
  
  
  METHODS
  This is a post hoc analysis of a cross-sectional study. Functioning, in the presence (overall pain score >30; Visual Analog Scale) or absence of PPS, was assessed using the Sheehan Disability Scale (SDS) in three groups of patients; 1) GAD and comorbid MDD (GAD+MDD+), 2) GAD without comorbid MDD (GAD+MDD-), 3) controls (GAD-MDD-). ANCOVA models were used.
  
  
  RESULTS
  Of those patients with GAD+MDD+ (n = 559), 436 (78.0%) had PPS, compared with GAD+MDD- (249 of 422, 59%) and controls (95 of 336, 28.3%). Functioning worsened in both GAD groups in presence of PPS (SDS least squares mean total score: 16.1 vs. 9.8, p < 0.0001, GAD+MDD+; 14.3 vs. 8.2, p < 0.0001, GAD+MDD-). The presence of PPS was significantly associated with less productivity.
  
  
  CONCLUSIONS
  Functional impairment related to the presence of PPS was relevant. Clinical implications should be considered.
authors.affiliation: Clinical Research Department, Lilly SA, Avenida de la Industria 30, Alcobendas, Spain. romera_irene@lilly.com
authors.forename: Irene
authors.initials: I
authors.lastname: Romera
authors.forename: Angel L
authors.initials: AL
authors.lastname: Montejo
authors.forename: Fernando
authors.initials: F
authors.lastname: Caballero
authors.forename: Luis
authors.initials: L
authors.lastname: Caballero
authors.forename: José
authors.initials: J
authors.lastname: Arbesú
authors.forename: Pepa
authors.initials: P
authors.lastname: Polavieja
authors.forename: Durisala
authors.initials: D
authors.lastname: Desaiah
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Gilaberte
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000523:psychology