Center for Health Outcomes Research, United BioSource Corporation, Bethesda, MD 20814, USA.
J Affect Disord. 2012 Oct;140(2):103-12. doi: 10.1016/j.jad.2011.11.014. Epub 2011 Dec 9.
To review the humanistic and economic burden of generalized anxiety disorder (GAD).
MEDLINE, EMBASE and the Cochrane Library, limited to articles published in English, between 1987 and 2010, in North America, Europe and Australia. The key focus was humanistic or functional outcomes, cost of illness and economic outcomes. Ninety articles fitting criteria on (a) GAD study population, (b) United States, Europe or Australia, and (c) humanistic burden or economic burden were reviewed. Methods and findings were summarized by two researchers; inconsistencies were resolved by a third reviewer.
GAD was associated with increased impairments in psychosocial functioning, role functioning, work productivity and health-related quality of life (HRQL). The HRQL impairments were comparable with those associated with depression or panic disorder. Patients with GAD and co-morbid depression reported significantly greater impairment in HRQL than did those with either disorder alone. GAD patients had significantly higher median medical costs than primary care patients without GAD (US $2375 versus $1448). The mean annual medical cost of GAD was $2138 higher than for other anxiety disorders (mean $6475). Finally, GAD was frequently under-recognized in primary care, and available studies reported that only 20% to 32% of patients were adequately treated.
The review was limited to pharmacologic treatments for GAD and to publications in English.
GAD is associated with significant burden on patient functioning and well-being, leading to increased health care utilization and medical costs. Patients with GAD are often suboptimally treated, which adds to the HRQL burden of this disorder.
综述广泛性焦虑障碍（GAD）的人文和经济负担。
检索 MEDLINE、EMBASE 和 Cochrane 图书馆，时间限定为 1987 年至 2010 年，仅限北美、欧洲和澳大利亚发表的英文文献。主要关注人文或功能结果、疾病成本和经济结果。符合以下标准的 90 篇文献纳入研究：（a）GAD 研究人群，（b）美国、欧洲或澳大利亚，（c）人文负担或经济负担。由两名研究人员总结方法和发现，由第三名评审员解决不一致问题。
GAD 与心理社会功能障碍、角色功能障碍、工作生产力和健康相关生活质量（HRQL）的损害增加有关。HRQL 的损害与抑郁或惊恐障碍相关的损害相当。与单独患有 GAD 或抑郁障碍的患者相比，同时患有 GAD 和共病抑郁的患者报告 HRQL 损害显著更大。GAD 患者的医疗费用中位数明显高于无 GAD 的初级保健患者（美国 2375 美元 vs. 1448 美元）。GAD 的年平均医疗费用比其他焦虑障碍高 2138 美元（平均 6475 美元）。最后，GAD 在初级保健中经常被低估，而且现有研究报告称，只有 20%至 32%的患者得到了充分治疗。
该综述仅限于 GAD 的药物治疗和英文文献。
GAD 给患者的功能和健康带来重大负担，导致医疗利用率和医疗成本增加。GAD 患者的治疗通常并不理想，这增加了这种疾病的 HRQL 负担。
