The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review.

Abstract:

BACKGROUND:To review the prevalence and impact of generalized anxiety disorder (GAD) below the diagnostic threshold and explore its treatment needs in times of scarce healthcare resources. METHODS:A systematic literature search was conducted until January 2013 using PUBMED/MEDLINE, PSYCINFO, EMBASE and reference lists to identify epidemiological studies of subthreshold GAD, i.e. GAD symptoms that do not reach the current thresholds of DSM-III-R, DSM-IV or ICD-10. Quality of all included studies was assessed and median prevalences of subthreshold GAD were calculated for different subpopulations. RESULTS:Inclusion criteria led to 15 high-quality and 3 low-quality epidemiological studies with a total of 48,214 participants being reviewed. Whilst GAD proved to be a common mental health disorder, the prevalence for subthreshold GAD was twice that for the full syndrome. Subthreshold GAD is typically persistent, causing considerably more suffering and impairment in psychosocial and work functioning, benzodiazepine and primary health care use, than in non-anxious individuals. Subthreshold GAD can also increase the risk of onset and worsen the course of a range of comorbid mental health, pain and somatic disorders; further increasing costs. Results are robust against bias due to low study quality. CONCLUSIONS:Subthreshold GAD is a common, recurrent and impairing disease with verifiable morbidity that claims significant healthcare resources. As such, it should receive additional research and clinical attention.

journal_name

BMC Psychiatry

journal_title

BMC psychiatry

authors

Haller H,Cramer H,Lauche R,Gass F,Dobos GJ

doi

10.1186/1471-244X-14-128

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

128

issn

1471-244X

pii

1471-244X-14-128

journal_volume

14

pub_type

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