Generalized anxiety disorder: epidemiology, burden, and comorbid depression

Generalized anxiety disorder (GAD) is a common long-term psychiatric disorder with varying prevalence in epidemiological studies. The burden of GAD is high and associated risk factors are not well documented in the general population.

This observational retrospective study of US adult patients with GAD used Optum's de-identified Clinformatics Data Mart Database to explore epidemiology, patient characteristics, risk factors, and disease burden. Adults with GAD were matched with a control general population.

A total of 1,086,618 US patients with GAD were included: mean patient age was 49.4 ± 19.1 years and 66.5% were female. Incidence of GAD increased from 0.8% in 2012 to 2.4% in 2022. One-year prevalence of GAD increased from 2.1% in 2012 to 7.4% in 2022. Individuals with GAD utilized healthcare resources more frequently than the matched control population. Retrospectively-assessed risk factors most associated with GAD were pre-existing major depressive disorder (odds ratio [OR] 5.06; 95% confidence interval [CI]: 5.03, 5.08; p < 0.001), family problems (OR 2.83 95% CI: 2.76, 2.89; p < 0.001), SARS-CoV-2 infection (OR 2.53; 95% CI: 2.48, 2.57; p < 0.001), employment difficulties (OR 2.48; 95% CI: 2.36, 2.60; p < 0.01), and attention deficit hyperactivity disorder (OR 2.19; 95% CI: 2.17, 2.21; p < 0.001).

Risk factors, particularly depressive symptoms, should be acknowledged during the diagnosis and management of patients with GAD to support optimal clinical outcomes.