To explore the consequences of broadening DSM-IV criteria for Generalized Anxiety Disorder (GAD) on patient's disability.

A multicentre and observational study was carried-out in outpatient psychiatric clinics in Spain between years 2007 and 2008. Naïve diagnosed patients with GAD according to DSM-IV criteria or with anxiety symptoms fulfilling broadened criteria were compared. At least 1-month of excessive or non-excessive worry along with only two of the associated symptoms listed on DSM-IV for GAD were considered as broadened GAD criteria. Socio-demographic data, medical history and functional outcome measures were recorded.

A total of 3,549 patients were systematically recruited, 12.8% excluded because not found eligible for inclusion in analysis; 1,815 in the DSM-IV group (DG) and 1,264 in the broadening criteria group (BG). Both groups were similar on their sociodemographic characteristics. Total disability score in the WHO-DAS II scale was slightly, but statistically significant, higher in DG; 41.9 (17.1) versus 38.9 (16.0) points, p < 0.05. These weak differences were observed in all of the scale domains but mainly in domains “Getting around” [34.5 (23.6) versus 29.4 (22.8), p< 0.05] and “Life activities” [55.5 (27.1) versus 52.1 (26.2), p< 0.05], since differences in the other domains, even statistically significant, were negligible.

Patients with standard DSM-IV criteria for GAD appears to show slightly, but significant, worst level of disability than subjects with broadening diagnostic GAD criteria. Life-activities and participation in society domains seems to be the functional domains most impacted by symptoms of anxiety.