title: Economic and humanistic burden of illness in generalized anxiety disorder: an analysis of patient survey data in Europe.
abstract: BACKGROUND
  Whilst studies suggest that generalized anxiety disorder (GAD) represents a considerable health care burden in Europe, there is a paucity of published evidence. This study investigated the burden of illness associated with GAD across five European countries (France, Germany, Italy, Spain, and the UK).
  
  
  METHODS
  Information from the 2008 European National Health and Wellness Survey database was analyzed. Bivariate, multivariate, and cost analyses were used to compare patients with GAD and propensity-matched controls.
  
  
  RESULTS
  Compared with non-GAD controls, patients with GAD had more comorbidities and were more likely to smoke but less likely to be employed, use alcohol, or take exercise. They also had significantly worse health-related quality of life, and significantly greater work impairment and resource use, which increased as GAD severity increased. Within-country analyses demonstrated results similar to those for the five European countries overall, with the largest differences in resource use between patients with GAD and non-GAD controls documented in France and Germany. The average mean differences in direct costs were relatively small between the GAD groups and controls; however, indirect costs differed substantially. Costs were particularly high in Germany, mainly due to higher salaries leading to higher costs associated with absence from work. The limitation of this study was that the data were from a self-reported Internet survey, making them subject to reporting bias and possibly sample bias.
  
  
  CONCLUSIONS
  Across all five European countries, GAD had a significant impact on work impairment, resource use, and economic costs, representing a considerable individual and financial burden that increased with severity of disease. These data may help us to understand better the burden and costs associated with GAD.
authors.affiliation: AstraZeneca R&D, Mölndal, Sweden.
authors.forename: Samira
authors.initials: S
authors.lastname: Toghanian
authors.affiliation: Kantar Health, New York, NY, USA.
authors.forename: Marco
authors.initials: M
authors.lastname: Dibonaventura
authors.affiliation: AstraZeneca R&D, Mölndal, Sweden.
authors.forename: Krister
authors.initials: K
authors.lastname: Järbrink
authors.affiliation: AstraZeneca Pharmaceuticals, Wilmington, DE, USA.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Locklear
keywords: Europe; burden of illness; economic burden; generalized anxiety disorder
references.citation: J Clin Psychiatry. 2008 Oct;69(10):1606-16
references.pmid: 19192444
references.citation: J Clin Psychiatry. 2009;70 Suppl 2:10-4
references.pmid: 19371501
references.citation: Eur Neuropsychopharmacol. 2005 Aug;15(4):445-52
references.pmid: 15951160
references.citation: J Psychosom Res. 1994;38 Suppl 1:151-60
references.pmid: 7799247
references.citation: Psychiatr Serv. 2006 Dec;57(12):1738-44
references.pmid: 17158488
references.citation: J Med Econ. 2010;13(4):662-72
references.pmid: 21034378
references.citation: Br J Psychiatry Suppl. 1998;(34):18-23
references.pmid: 9829012
references.citation: Psychol Med. 2002 Oct;32(7):1213-25
references.pmid: 12420891
references.citation: Depress Anxiety. 2008;25(1):72-90
references.pmid: 17146763
references.citation: World J Biol Psychiatry. 2008;9(4):248-312
references.pmid: 18949648
references.citation: Br J Psychiatry. 2003 Oct;183:299-303
references.pmid: 14519607
references.citation: Int J Geriatr Psychiatry. 2003 Nov;18(11):994-1001
references.pmid: 14618550
references.citation: Br J Psychiatry Suppl. 1998;(34):4-9
references.pmid: 9829010
references.citation: Eur J Neurol. 2005 Jun;12 Suppl 1:39-44
references.pmid: 15877777
references.citation: Pharmacoeconomics. 1993 Nov;4(5):353-65
references.pmid: 10146874
references.citation: Arch Gen Psychiatry. 1994 May;51(5):355-64
references.pmid: 8179459
references.citation: Behav Ther. 2010 Mar;41(1):59-72
references.pmid: 20171328
references.citation: J Clin Psychiatry. 2009;70 Suppl 2:20-4
references.pmid: 19371503
references.citation: Clin Ther. 2009 Jun;31(6):1279-308
references.pmid: 19695395
references.citation: J Clin Psychiatry. 1988 Oct;49 Suppl:17-9
references.pmid: 3049562
references.citation: Am J Psychiatry. 1985 Jul;142(7):787-97
references.pmid: 2861752
references.citation: Med Care. 2004 Sep;42(9):851-9
references.pmid: 15319610
references.citation: Arch Gen Psychiatry. 2007 Jun;64(6):651-60
references.pmid: 17548747
references.citation: Curr Med Res Opin. 2007 Oct;23(10):2543-9
references.pmid: 17825130
references.citation: Curr Med Res Opin. 2013 Apr;29(4):355-67
references.pmid: 23356728
references.citation: Depress Anxiety. 2002;16(4):162-71
references.pmid: 12497648
references.citation: J Clin Psychiatry. 1999 Jul;60(7):427-35
references.pmid: 10453795
references.citation: J Clin Psychiatry. 2002;63 Suppl 8:24-34
references.pmid: 12044105
references.citation: Am J Psychiatry. 2000 May;157(5):669-82
references.pmid: 10784456
references.citation: Am J Psychiatry. 1993 Apr;150(4):600-7
references.pmid: 8465877