Gender Differences in Generalized Anxiety Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, 1051 Riverside Dr., New York, NY 10032, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 01/2009; 69(10):1606-16. DOI: 10.4088/JCP.v69n1011
Source: PubMed


To assess gender differences in the epidemiology, comorbidity, and treatment-seeking patterns of DSM-IV generalized anxiety disorder (GAD) in the United States.
Data were derived from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey of a representative sample (N = 43,093) of the U.S. population.
The lifetime and 12-month male:female prevalence ratios of DSM-IV GAD were 1:1.9 and 1:2.2, respectively. Men with GAD had significantly higher rates of comorbid alcohol and drug use disorders, nicotine dependence, and antisocial personality disorder. Women with GAD had significantly higher rates of comorbid mood disorders (except bipolar disorder) and anxiety disorders (except social anxiety disorder). Men with GAD reported greater use of alcohol and drugs to help relieve GAD symptoms. GAD in women was associated with higher rates of family history of depression. Disability associated with GAD was greater in women than in men. Rates of treatment seeking for DSM-IV GAD were low for both genders, but particularly low among men.
There are significant gender differences in the prevalence, comorbidity pattern, sociodemographic and clinical correlates, course, and treatment-seeking rates of persons with DSM-IV GAD. Increased recognition and treatment of GAD, particularly among men, could lead to substantial reductions in the societal and personal burden and improve the quality of life of those afflicted with this disorder.

Full-text preview

Available from:
  • Source
    • "Generalized anxiety disorder (GAD) is a disabling psychiatric illness characterized by excessive worry, without specific cause, for a period of at least 6 months.1 GAD is often a chronic condition and is associated with reduced health-related quality of life (HRQoL) and psychosocial functioning, low overall life satisfaction, and impairment in the ability to fulfill roles and social tasks.2 GAD is twice as common in women as in men3,4 and is often comorbid with other psychiatric disorders and/or medical conditions.5–9 Considerable variability in prevalence has been observed between European countries;10,11 however, in Europe overall, the 12-month prevalence of GAD is estimated to be approximately 2% of the adult population,12 with higher rates (5.3%) reported for patients receiving treatment in the primary care setting.13 "
    [Show abstract] [Hide abstract]
    ABSTRACT: Whilst studies suggest that generalized anxiety disorder (GAD) represents a considerable health care burden in Europe, there is a paucity of published evidence. This study investigated the burden of illness associated with GAD across five European countries (France, Germany, Italy, Spain, and the UK). Information from the 2008 European National Health and Wellness Survey database was analyzed. Bivariate, multivariate, and cost analyses were used to compare patients with GAD and propensity-matched controls. Compared with non-GAD controls, patients with GAD had more comorbidities and were more likely to smoke but less likely to be employed, use alcohol, or take exercise. They also had significantly worse health-related quality of life, and significantly greater work impairment and resource use, which increased as GAD severity increased. Within-country analyses demonstrated results similar to those for the five European countries overall, with the largest differences in resource use between patients with GAD and non-GAD controls documented in France and Germany. The average mean differences in direct costs were relatively small between the GAD groups and controls; however, indirect costs differed substantially. Costs were particularly high in Germany, mainly due to higher salaries leading to higher costs associated with absence from work. The limitation of this study was that the data were from a self-reported Internet survey, making them subject to reporting bias and possibly sample bias. Across all five European countries, GAD had a significant impact on work impairment, resource use, and economic costs, representing a considerable individual and financial burden that increased with severity of disease. These data may help us to understand better the burden and costs associated with GAD.
    Full-text · Article · Apr 2014 · ClinicoEconomics and Outcomes Research
  • Source
    • "GAD tends to be a chronic disorder with waxing and waning of the symptoms. Disability associated with GAD is known to be greater in women than in men.28 Therefore, lower sulphydryl levels in female patients may be related with the greater disability previously reported in female GAD patients. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In recent years, many published studies have focused on the relationship between oxidative stress and psychiatric disorders. However, studies in generalized anxiety disorder (GAD) are few despite relatively high prevalence rates. In an attempt to fill this gap in the literature we aimed to measure serum levels of free sulphydryl, an important member of antioxidant defense mechanisms, of the patients with GAD. A total of 35 (23 female, 12 male) GAD patients without any other co-morbid medical or psychiatric disorder and 35 (23 female, 12 male) healthy controls have been included in the study. Disease severity of the patients were quantified by using the Hamilton Anxiety Rating Scale (HAM-A). Serum free sulphydryl group levels of patients and healthy controls were measured in an appropriate way. Mean level of serum sulphydryl groups was significantly lower in the patient group. There was a negative correlation between their level and the disease duration. However, they did not show any significant correlation with the disease severity. Decreased serum sulphydryl level observed in pure GAD patients suggests an increased oxidative stress in these patients. Well designed future researches are needed to replicate our findings and to test the implications of the present study.
    Full-text · Article · Sep 2013 · Psychiatry investigation
  • Source
    • "These questions queried about touching and fondling, touching in a sexual way and attempting or actually having sexual intercourse. Negative family environment measures include vulnerable family environment operationalized, as in prior studies, as parental absence or separation from a biological parent before age 18 (Alegria et al., 2010; Vesga-López et al., 2008), parental divorce, parental history of alcohol and drug use problems, parental behavioral problem, and partner with alcohol problem. 2.2.3. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Despite the high rates of comorbidity of post-traumatic stress disorder (PTSD) and alcohol dependence (AD) in clinical and epidemiological samples, little is known about the prevalence, clinical presentation, course, risk factors and patterns of treatment-seeking of co-occurring PTSD-AD among the general population. Methods: The sample included respondents of the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Weighted means, frequencies and odds ratios (ORs) of sociodemographic correlates, prevalence of psychiatric disorders and rates of treatment-seeking were computed. Results: In the general population, the lifetime prevalence of PTSD only, AD only and PTSD-AD was 4.83%, 13.66% and 1.59%, respectively. Individuals with comorbid PTSD-AD were more likely than those with PTSD or AD only to have suffered childhood adversities and had higher rates of Axis I and II disorders and suicide attempts. They also met more PTSD diagnostic criteria, had earlier onset of PTSD and were more likely to use drugs and alcohol to relieve their PTSD symptoms than those with PTSD only; they also met more AD diagnostic criteria than those with AD only and had greater disability. Individuals with PTSD-AD had higher rates of treatment seeking for AD than those with AD only, but similar rates than those with PTSD only. Conclusion: PTSD-AD is associated with high levels of severity across a broad range of domains even compared with individuals with PTSD or AD only, yet treatment-seeking rates are very low. There is a need to improve treatment access and outcomes for individuals with PTSD-AD.
    Full-text · Article · May 2013 · Drug and alcohol dependence
Show more