Abstract:
Importance:Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, and debates persist about the seriousness of this disorder. Few data exist on GAD outside a small number of affluent, industrialized nations. No population-based data exist on GAD as it is currently defined in DSM-5. Objective:To provide the first epidemiologic data on DSM-5 GAD and explore cross-national differences in its prevalence, course, correlates, and impact. Design, Setting, and Participants:Data come from the World Health Organization World Mental Health Survey Initiative. Cross-sectional general population surveys were carried out in 26 countries using a consistent research protocol and assessment instrument. A total of 147 261 adults from representative household samples were interviewed face-to-face in the community. The surveys were conducted between 2001 and 2012. Data analysis was performed from July 22, 2015, to December 12, 2016. Main Outcomes and Measures:The Composite International Diagnostic Interview was used to assess GAD along with comorbid disorders, role impairment, and help seeking. Results:Respondents were 147 261 adults aged 18 to 99 years. The surveys had a weighted mean response rate of 69.5%. Across surveys, DSM-5 GAD had a combined lifetime prevalence (SE) of 3.7% (0.1%), 12-month prevalence of 1.8% (0.1%), and 30-day prevalence of 0.8% (0). Prevalence estimates varied widely across countries, with lifetime prevalence highest in high-income countries (5.0% [0.1%]), lower in middle-income countries (2.8% [0.1%]), and lowest in low-income countries (1.6% [0.1%]). Generalized anxiety disorder typically begins in adulthood and persists over time, although onset is later and clinical course is more persistent in lower-income countries. Lifetime comorbidity is high (81.9% [0.7%]), particularly with mood (63.0% [0.9%]) and other anxiety (51.7% [0.9%]) disorders. Severe role impairment is common across life domains (50.6% [1.2%]), particularly in high-income countries. Treatment is sought by approximately half of affected individuals (49.2% [1.2%]), especially those with severe role impairment (59.4% [1.8%]) or comorbid disorders (55.8% [1.4%]) and those living in high-income countries (59.0% [1.3%]). Conclusions and Relevance:The findings of this study show that DSM-5 GAD is more prevalent than DSM-IV GAD and is associated with substantial role impairment. The disorder is especially common and impairing in high-income countries despite a negative association between GAD and socioeconomic status within countries. These results underscore the public health significance of GAD across the globe while uncovering cross-national differences in prevalence, course, and impairment that require further investigation.
journal_name
JAMA Psychiatryjournal_title
JAMA psychiatryauthors
Ruscio AM,Hallion LS,Lim CCW,Aguilar-Gaxiola S,Al-Hamzawi A,Alonso J,Andrade LH,Borges G,Bromet EJ,Bunting B,Caldas de Almeida JM,Demyttenaere K,Florescu S,de Girolamo G,Gureje O,Haro JM,He Y,Hinkov H,Hu C,de Jongedoi
10.1001/jamapsychiatry.2017.0056subject
Has Abstractpub_date
2017-05-01 00:00:00pages
465-475issue
5eissn
2168-622Xissn
2168-6238pii
2608757journal_volume
74pub_type
杂志文章相关文献
JAMA Psychiatry文献大全abstract:IMPORTANCE:A major public health concern associated with schizophrenia and psychotic disorders is the long-term disability that involves impaired cognition, lack of social support, and an inability to function independently in the community. A critical goal of early detection and intervention studies in psychosis is th...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.1909
更新日期:2013-11-01 00:00:00
abstract:Importance:A relapse into nicotine addiction during abstinence often occurs after the reactivation of nicotine reward memories, either by acute exposure to nicotine (a smoking episode) or by smoking-associated conditioned stimuli (CS). Preclinical studies suggest that drug reward memories can undergo memory reconsolida...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2016.3907
更新日期:2017-03-01 00:00:00
abstract:Importance:Since the release of the DSM-5 diagnosis of attenuated psychosis syndrome (DSM-5-APS) in 2013, several research studies have investigated its clinical validity. Although critical and narrative reviews have reviewed these progresses, no systematic review has comprehensively summarized the available evidence r...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2019.3561
更新日期:2020-03-01 00:00:00
abstract:Importance:Publicly funded mental health services play an important role in addressing co-occurring mental health problems in children with autism spectrum disorder (ASD); however, therapists report lacking training to effectively serve this complex population. Objective:To test the effectiveness of training community...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2019.0011
更新日期:2019-06-01 00:00:00
abstract:Importance:Antipsychotic medications are commonly used to treat nonpsychotic disruptive behavioral disorders in youths. Objective:To characterize the metabolic effects of first exposure to antipsychotics in youths using criterion standard assessments of body composition and insulin sensitivity. Design, Setting, and P...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2018.1088
更新日期:2018-08-01 00:00:00
abstract:IMPORTANCE:The 16p11.2 BP4-BP5 duplication is the copy number variant most frequently associated with autism spectrum disorder (ASD), schizophrenia, and comorbidities such as decreased body mass index (BMI). OBJECTIVES:To characterize the effects of the 16p11.2 duplication on cognitive, behavioral, medical, and anthro...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2015.2123
更新日期:2016-01-01 00:00:00
abstract:Importance:Preeclampsia during pregnancy has been linked to an increased risk of cerebral palsy in offspring. Less is known about the role of preeclampsia in other neurodevelopmental disorders. Objective:To determine the association between preeclampsia and a range of adverse neurodevelopmental outcomes in offspring a...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.0306
更新日期:2020-08-01 00:00:00
abstract:IMPORTANCE:Recent estimates indicate that 6.5 million adolescents and young adults in the United States are neither in school nor working. These youth have significant mental health concerns that require intervention. OBJECTIVE:To determine whether a mental health intervention, integrated into an employment training p...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2014.2022
更新日期:2015-01-01 00:00:00
abstract:Importance:There is concern about potentially causal effects of tobacco use on psychosis, but epidemiological studies have been less robust in attempts to minimize effects of confounding than studies of cannabis use have been. Objectives:To examine the association of patterns of cigarette and cannabis use with precedi...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2017.4271
更新日期:2018-03-01 00:00:00
abstract:IMPORTANCE:The requirement of a childhood onset has always been a key criterion for the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adults, but recently this requirement has become surrounded by controversy. OBJECTIVE:To investigate whether impaired young adults with ADHD symptoms always have a chi...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2016.0383
更新日期:2016-07-01 00:00:00
abstract:Importance:Fatal self-injury in the United States associated with deliberate behaviors is seriously underestimated owing to misclassification of poisoning suicides and mischaracterization of most drug poisoning deaths as "accidents" on death certificates. Objective:To compare national trends and patterns of self-injur...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2016.1870
更新日期:2016-10-01 00:00:00
abstract:Importance:Autism spectrum disorder (ASD) is 2 to 5 times more common in male individuals than in female individuals. While the male preponderant prevalence of ASD might partially be explained by sex differences in clinical symptoms, etiological models suggest that the biological male phenotype carries a higher intrins...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2016.3990
更新日期:2017-04-01 00:00:00
abstract:Importance:Cognitive impairment occurs across the psychosis spectrum and is associated with functional outcome. However, it is unknown whether these shared manifestations of cognitive dysfunction across diagnostic categories also reflect shared neurobiological mechanisms or whether the source of impairment differs. Ob...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2017.0669
更新日期:2017-06-01 00:00:00
abstract:IMPORTANCE:The structural abnormalities in the brain that accurately differentiate unipolar depression (UD) and bipolar depression (BD) remain unidentified. OBJECTIVES:First, to investigate and compare morphometric changes in UD and BD, and to replicate the findings at 2 independent neuroimaging sites; second, to diff...
journal_title:JAMA psychiatry
pub_type: 杂志文章,多中心研究
doi:10.1001/jamapsychiatry.2014.1100
更新日期:2014-11-01 00:00:00
abstract:IMPORTANCE:Cigarette smoking leads to upregulation of nicotinic acetylcholine receptors (nAChRs) in the human brain, including the common α4β2* nAChR subtype. While subjective aspects of tobacco dependence have been extensively examined as predictors of quitting smoking with treatment, no studies to our knowledge have ...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2014.138
更新日期:2014-07-01 00:00:00
abstract:Importance:Deviation from normal adolescent brain development precedes manifestations of many major psychiatric symptoms. Such altered developmental trajectories in adolescents may be linked to genetic risk for psychopathology. Objective:To identify genetic variants associated with adolescent brain structure and explo...
journal_title:JAMA psychiatry
pub_type: 杂志文章,多中心研究
doi:10.1001/jamapsychiatry.2018.4126
更新日期:2019-04-01 00:00:00
abstract::CONTEXT Clinical experience and factor analytic studies suggest that some psychiatric disorders may be more closely related to one another, as indicated by the frequency of their co-occurrence, which may have etiologic and treatment implications. OBJECTIVE To construct a virtual space of common psychiatric disorders, ...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.281
更新日期:2013-02-01 00:00:00
abstract:IMPORTANCE:Neurobiological models of obsessive-compulsive disorder (OCD) predict hyperactivity in brain circuits involving the orbitofrontal cortex and the basal ganglia, but it is unclear whether these areas are also characterized by altered brain network properties. OBJECTIVES:To determine regions of abnormal degree...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.173
更新日期:2013-06-01 00:00:00
abstract:IMPORTANCE:In schizophrenia, working memory deficits appear to reflect abnormalities in the generation of gamma oscillations in the dorsolateral prefrontal cortex. The generation of gamma oscillations requires the phasic excitation of inhibitory parvalbumin-containing interneurons. Thus, gamma oscillations depend, in p...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2015.0533
更新日期:2015-08-01 00:00:00
abstract:IMPORTANCE:National epidemiologic information from recently collected data on the new DSM-5 classification of alcohol use disorder (AUD) using a reliable, valid, and uniform data source is needed. OBJECTIVE:To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, associated...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2015.0584
更新日期:2015-08-01 00:00:00
abstract:Importance:This article briefly reports the experience of mental health services and the lessons learned during the coronavirus disease 2019 (COVID-19) crisis. In particular, this report offers opportunities to build on experience gained in managing the COVID-19 emergency in the Departments of Mental Health and Addicti...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.1276
更新日期:2020-09-01 00:00:00
abstract:IMPORTANCE:The continuum view of the psychosis spectrum (PS) implies that, in population-based samples, PS symptoms should be associated with neural abnormalities similar to those found in help-seeking clinical risk individuals and in schizophrenia. To our knowledge, functional neuroimaging has not previously been appl...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2014.3169
更新日期:2015-05-01 00:00:00
abstract:Importance:Tobacco use disorder is associated with dysregulated neurocognitive function in the right inferior frontal gyrus (IFG)-one node in a corticothalamic inhibitory control (IC) network. Objective:To examine associations between IC neural circuitry structure and function and lapse/relapse vulnerability in 2 inde...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2017.0017
更新日期:2017-04-01 00:00:00
abstract:Importance:Bipolar disorder (BD) overlaps schizophrenia in its clinical presentation and genetic liability. Alternative approaches to patient stratification beyond current diagnostic categories are needed to understand the underlying disease processes and mechanisms. Objective:To investigate the association between co...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2017.3485
更新日期:2018-01-01 00:00:00
abstract:IMPORTANCE:Although high rates of current mental disorder are known to exist in the US Army, little is known about the proportions of these disorders that had onsets prior to enlistment. OBJECTIVE:To estimate the proportions of 30-day DSM-IV mental disorders among nondeployed US Army personnel with first onsets prior ...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2014.28
更新日期:2014-05-01 00:00:00
abstract:IMPORTANCE:Some, but not all, previous magnetic resonance imaging studies have indicated smaller cortical and local gray matter volumes (GMVs) in men with schizotypal personality disorder (SPD) compared with healthy control (HC) subjects. Thus, there is need for a whole-brain comparison to resolve inconsistencies and p...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.665
更新日期:2013-04-01 00:00:00
abstract:IMPORTANCE:Studies have shown that the scientific literature has overestimated the efficacy of antidepressants for depression, but other indications for these drugs have not been considered. OBJECTIVE:To examine reporting biases in double-blind, placebo-controlled trials on the pharmacologic treatment of anxiety disor...
journal_title:JAMA psychiatry
pub_type: 杂志文章,meta分析
doi:10.1001/jamapsychiatry.2015.15
更新日期:2015-05-01 00:00:00
abstract:IMPORTANCE:Posttraumatic stress disorder (PTSD) is a common, debilitating mental disorder that has been associated with type 2 diabetes mellitus (T2D) and its risk factors, including obesity, in cross-sectional studies. If PTSD increases risk of incident T2D, enhanced surveillance in high-risk populations may be warran...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2014.2632
更新日期:2015-03-01 00:00:00
abstract::Suicide rates have continued to rise in the United States. Speculations for this rise proliferate but the causes for the increase remain unknown. While research focuses on identifying causes, the health care system is an important site for identification of patients at risk. Forty percent of individuals who die by sui...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2019.2769
更新日期:2020-01-01 00:00:00
abstract:IMPORTANCE:Cocaine addiction is associated with altered resting-state functional connectivity among regions of the mesocorticolimbic dopamine pathways. Methylphenidate hydrochloride, an indirect dopamine agonist, normalizes task-related regional brain activity and associated behavior in cocaine users; however, the neur...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2013.1129
更新日期:2013-08-01 00:00:00