Generalized anxiety disorder: epidemiology, burden, and comorbid depression

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