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Implications for modifying the duration requirement of generalized anxiety disorder in developed and developing countries

Citation

Lee, S and Tsang, A and Ruscio, AM and Haro, JM and Stein, DJ and Alonso, J and Angermeyer, MC and Bromet, EJ and Demyttenaere, K and de Girolamo, G and de Graaf, R and Gureje, O and Iwata, N and Karam, EG and Lepine, JP and Levinson, D and Medina-Mora, ME and Oakley Browne, M and Posada-Villa, J and Kessler, RC, Implications for modifying the duration requirement of generalized anxiety disorder in developed and developing countries, Psychological Medicine, 39, (7) pp. 1163-1176. ISSN 0033-2917 (2009) [Refereed Article]

DOI: doi:10.1017/S0033291708004807

Abstract

Background. A number of western studies have suggested that the 6-month duration requirement of generalized anxiety disorder (GAD) does not represent a critical threshold in terms of onset, course, or risk factors of the disorder. No study has examined the consequences of modifying the duration requirement across a wide range of correlates in both developed and developing countries. Method. Population surveys were carried out in seven developing and 10 developed countries using the WHO Composite International Diagnostic Interview (total sample=85 052). Prevalence and correlates of GAD were compared across mutually exclusive GAD subgroups defined by different minimum duration criteria. Results. Lifetime prevalence estimates for GAD lasting 1 month, 3 months, 6 months and 12 months were 7.5%, 5.2%, 4.1% and 3.0% for developed countries and 2.7%, 1.8%, 1.5% and 1.2% for developing countries, respectively. There was little difference between GAD of 6 months' duration and GAD of shorter durations (1-2 months, 3-5 months) in age of onset, symptom severity or persistence, co-morbidity or impairment. GAD lasting ≥12 months was the most severe, persistently symptomatic and impaired subgroup. Conclusions. In both developed and developing countries, the clinical profile of GAD is similar regardless of duration. The DSM-IV 6-month duration criterion excludes a large number of individuals who present with shorter generalized anxiety episodes which may be recurrent, impairing and contributory to treatment-seeking. Future iterations of the DSM and ICD should consider modifying the 6-month duration criterion so as to better capture the diversity of clinically salient anxiety presentations. © 2008 Cambridge University Press.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Mental Health
Objective Division:Health
Objective Group:Public Health (excl. Specific Population Health)
Objective Field:Mental Health
Author:Oakley Browne, M (Professor Mark Oakley Browne)
ID Code:63272
Year Published:2009
Web of Science® Times Cited:26
Deposited By:Medicine (Discipline)
Deposited On:2010-04-27
Last Modified:2011-07-28
Downloads:0

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