title: The burden of generalized anxiety disorder in Canada.
abstract: BACKGROUND
  Although generalized anxiety disorder (GAD) is common and disabling, there are few Canadian studies on this mental illness. We compared the characteristics, health status, health services use and health care needs of Canadians with GAD to those with depression.
  
  
  METHODS
  Data are from the 2012 Canadian Community Health Survey-Mental Health, which surveyed a nationally representative sample of Canadians aged 15 years and older (n = 23 709; response rate of 68.9%). The respondents we studied had selfreported symptoms compatible with GAD and/or major depressive episode (MDE) in the preceding 12 months (n = 1598). Estimates were weighted to represent the Canadian household population. We performed descriptive and multinomial multivariate logistic regression analyses.
  
  
  RESULTS
  In 2012, an estimated 700 000 (2.5%) Canadians aged 15 years and older reported symptoms compatible with GAD in the previous 12 months. MDE symptoms co-occurred in 50% of these individuals. Those with GAD only reported fair/poor perceived health (29.7%), moderate to severe psychological distress (81.2%) and moderate to severe disability (28.1%) comparable to (or even slightly worse) than those with MDE only (24.7%, 78.8% and 24.8% respectively). Those with comorbid GAD and MDE demonstrated the worst health outcomes; 47.3% of them reported fair/poor perceived health, 94.0% reported moderate to severe psychological distress and 52.4% reported moderate to severe disability. Nearly 50% of those with comorbid GAD and MDE reported that their need for health care was not met or only partially met, compared to about 30% of those with GAD or MDE only.
  
  
  CONCLUSIONS
  While GAD is associated with levels of distress and disability comparable to (or slightly worse) than those affected by MDE only, the health status of those with comorbid disease is significantly worse than those with GAD or MDE only. Improved diagnosis, screening for comorbidity and management are essential to minimize the impacts of this mental illness.
authors.affiliation: Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: Louise
authors.initials: L
authors.lastname: Pelletier
authors.affiliation: Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: Siobhan
authors.initials: S
authors.lastname: O'Donnell
authors.affiliation: Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: Louise
authors.initials: L
authors.lastname: McRae
authors.affiliation: Institut de recherche de l'Hôpital Montfort (IRHM), C.T. Lamont Primary Health Care Research Centre, Ottawa, Ontario, Canada.|Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Grenier
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000628:therapy*; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000628:therapy; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D057566:Self Report; D013315:Stress, Psychological / Q000453:epidemiology; D055815:Young Adult
keywords: Canada; disability; generalized anxiety disorder; impact; major depressive episode; prevalence