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Functioning and disability levels in primary care out-patients with one or more anxiety disorders

Published online by Cambridge University Press:  11 February 2010

C. D. Sherbourne ,
G. Sullivan ,
M. G. Craske ,
P. Roy-Byrne ,
D. Golinelli ,
R. D. Rose ,
D. A. Chavira ,
A. Bystritsky  and
M. B. Stein
C. D. Sherbourne*
Affiliation:
Health Program, RAND Corporation, Santa Monica, CA, USA
G. Sullivan
Affiliation:
Health Program, RAND Corporation, Santa Monica, CA, USA South Central VA Mental Illness Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA Department of Psychiatry, Division of Health Services Research, University of Arkansas for Medical Sciences, Little Rock, AR, USA
M. G. Craske
Affiliation:
Department of Psychology, University of California, Los Angeles, CA, USA
P. Roy-Byrne
Affiliation:
Department of Psychiatry, University of Washington School of Medicine, Seattle, WA, USA Harborview Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations, Seattle, WA, USA
D. Golinelli
Affiliation:
Health Program, RAND Corporation, Santa Monica, CA, USA
R. D. Rose
Affiliation:
Department of Psychology, University of California, Los Angeles, CA, USA
D. A. Chavira
Affiliation:
Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA Child and Adolescent Services Research Center, San Diego, CA, USA
A. Bystritsky
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
M. B. Stein
Affiliation:
Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA
*
*Address for correspondence: C. D. Sherbourne, Ph.D., RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, USA. (Email: [email protected])
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Abstract

Background

Anxiety disorders are the most prevalent mental health disorders and are associated with substantial disability and reduced well-being. It is unknown whether the relative impact of different anxiety disorders is due to the anxiety disorder itself or to the co-occurrence with other anxiety disorders. This study compared the functional impact of combinations of anxiety disorders in primary care out-patients.

Method

A total of 1004 patients with panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD) or post-traumatic stress disorder (PTSD) provided data on their mental and physical functioning, and disability. Multivariate regressions compared functional levels for patients with different numbers and combinations of disorders.

Results

Of the patients, 42% had one anxiety disorder only, 38% two, 16% three and 3% all four. There were few relative differences in functioning among patients with only one anxiety disorder, although those with SAD were most restricted in their work, social and home activities and those with GAD were the least impaired. Functioning levels tended to deteriorate as co-morbidity increased.

Conclusions

Of the four anxiety disorders examined, GAD appears to be the least disabling, although they all have more in common than in distinction when it comes to functional impairment. A focus on unique effects of specific anxiety disorders is inadequate, as it fails to address the more pervasive impairment associated with multiple anxiety disorders, which is the modal presentation in primary care.

Keywords

Disabilityfunctioningmultiple anxiety disorders
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 12 , December 2010 , pp. 2059 - 2068
Copyright
Copyright © Cambridge University Press 2010

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