Pain related factors in newly diagnosed Generalized Anxiety Disorder patients

To determine the prevalence and factors associated to painful physical symptoms (PPS), pain as presentation, and neuropathic pain in generalized anxiety disorder (GAD) at primary care setting.

Multicenter, cross-sectional, observational study conducted on 404 Spanish primary care centers with 2,232 patients. Data was collected at once and included demographic data, main reason for visit, psychiatric and medical illnesses, healthcare resource utilization. Validated scales used for GAD diagnosis were the MINI interview and GAD-7 scale. Depression was measured with the Hospital Anxiety and Depression Scale, sleep disturbances with the MOS-Sleep Scale, and pain with the Brief Pain Inventory, short version.

Most patients reported PPS (93.5%). The main associated factors of PPS were consultation for gastrointestinal disease (OR=3.9) or for depression (OR=2.2), and being women (OR=1.5). PPS were the reason for visiting in 72.4 % of the sample. The main associated factors of PPS as the reason for consultation were clinical discomfort due to anxiety (OR=2.0), being female (OR=1.6), comorbid social anxiety (OR=1.4), and high Body Mass Index (OR=1.04). Neuropathic pain was present in 59.4% of all patients. Patients with diabetes (OR=2.6), social anxiety (OR=1.6), and depression (OR=1,6) suffered more frequently from neuropathic pain.

This is the first study to establish the associated factors of PPS, neuropathic pain and pain as main reason for visiting in primary care patients with newly diagnosed GAD. Better knowledge factors associated to GAD could help to reduce its underdiagnosis and undertreatment at the primary care level.