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

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

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

Haller, H Cramer, H

Lauche, R

Gass, F Dobos, GJ

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Publication Type:: Journal Article
Citation:: BMC Psychiatry, 2014, 14 (1)
Issue Date:: 2014-05-01

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Field	Value	Language
dc.contributor.author	Haller, H	en_US
dc.contributor.author	Cramer, H https://orcid.org/0000-0002-3640-8046	en_US
dc.contributor.author	Lauche, R https://orcid.org/0000-0002-4171-7935	en_US
dc.contributor.author	Gass, F	en_US
dc.contributor.author	Dobos, GJ	en_US
dc.date.available	2014-04-23	en_US
dc.date.issued	2014-05-01	en_US
dc.identifier.citation	BMC Psychiatry, 2014, 14 (1)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/41528
dc.description.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. © 2014 Haller et al.; licensee BioMed Central Ltd.	en_US
dc.relation.ispartof	BMC Psychiatry	en_US
dc.relation.isbasedon	10.1186/1471-244X-14-128	en_US
dc.subject.classification	Psychiatry	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Prevalence	en_US
dc.subject.mesh	Anxiety Disorders	en_US
dc.subject.mesh	Comorbidity	en_US
dc.subject.mesh	Cost of Illness	en_US
dc.subject.mesh	Diagnostic and Statistical Manual of Mental Disorders	en_US
dc.subject.mesh	International Classification of Diseases	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Primary Health Care	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	The prevalence and burden of subthreshold generalized anxiety disorder: A systematic review	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	14	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1701 Psychology	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	14	en_US

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. © 2014 Haller et al.; licensee BioMed Central Ltd.

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http://hdl.handle.net/10453/41528