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Generalized Anxiety Disorder |
Overcoming Anxiety (Home) > Generalized Anxiety Disorder > Course Course for Generalized Anxiety DisorderGAD is a disorder characterised by extreme anxiety and worry. Its age of onset is between the late teens and early twenties. In most studies, the average duration of GAD was 20 years, suggesting a chronic course. Stress seems to play an important role in GAD onset. There have been studies showing genetic factors to predispose to its onset. GAD can be divided in two subgroups. The early-onset subgroup usually suffers with subclinical anxiety symptoms. These patients have always been anxious, withdrawn, socially sensitive and maladjusted worriers. The late-onset subgroup shows a better social adjustment; unfavourable events provoke the onset of the disorder. However, although the circumstances of onset are different, once the condition has developed, the symptomatology is largely similar in both groups. This stresses the significance of longitudinal studies to complement cross-ectional studies in analysing the course of the disorder. The Epidemiologic Catchment Area Study (ECA) found a higher GADprevalence (DSM-III diagnosis) in women, in persons under 30 years old and in the black population. The prevalence of lifetime GAD was higher in urban areas and in low-income brackets. This study could not find a clear relationship with the level of education. Risk factors were also assessed in the National Comorbidity Survey. Like the ECA study, GAD prevalence in women was higher (twice as common as among men). On the contrary, the GAD prevalence in young persons was lower. In persons older than 24 years, being separated, divorced, widowed, unemployed and a homemaker were significant correlates of GAD. Most GAD patients reported a high interference with their lives (49%). Some 66% sought professional help, and 44% had received medical treatment. Approximately half of the GAD patients went to the primary care sector. In contrast, GAD subjects who had comorbid psychiatric disorders sought help in mental health centres. The presence of a more ‘‘differentiated mental disorder’’ being correlated to specialised care has been repeatedly mentioned in other studies. According to a study carried out by Massion et al, one-third of GAD patients are single, and 1701, of them are separated, widowed or divorced. GAD patients have been found underemployed, while 37% receive public assistance. GAD patients demonstrate difficulties at work, have social adjustment problems, and show a low self-satisfaction with their lives. Yonkers et al. found a low GAD remission rate of 0.15 after one year. These data are consistent with Noyes et al. and Kendler et al. According to Yonkers, the complete remission rate after two years was 0.25. Most patients’ symptoms stood at a stable level. In the rare patients with complete remission, relapse risk was 0.07 after six months and 0.15 one year later. Relapse risk was higher for those patients with partial remission and for those patients who showed comorbidity with other anxiety or depressive disorders. In spite of a complete GAD remission, approximately half of them showed symptoms related to a comorbid psychiatric disorder Summarising, GAD is a common and chronic disorder, which frequently leads to significant distress and serious functional impairment. It specially affects women. GAD patients generally visit primary care centres and are in need of medical treatment.
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