University of Cagliari, Cagliari, Italy.
Department of Neuroscience "Rita Levi Montalcini", University of Turin, via Cherasco 15, 10126, Turin, Italy.
BMC Psychiatry. 2021 Jan 20;21(1):48. doi: 10.1186/s12888-021-03042-3.
Generalized anxiety disorder (GAD) is one of the most reported diagnoses in psychiatry, but there is some discrepancy between the cases identified in community studies and those identified in tertiary care. This study set out to evaluate whether the use of clinicians as interviewers may provide estimates in a community survey close to those observed in primary or specialized care.
This is a community survey on a randomly selected sample of 2338 adult subjects. The Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS) was administered by clinicians, providing lifetime diagnosis based on the DSM-IV-TR. Health-related quality of life (HR-QoL) was measured with the Short-Form Health Survey (SF-12).
Overall, 55 (2.3%) subjects met the criteria for GAD, with greater prevalence in women (3.6%) than in men (0.9%): OR = 4.02; 95%CI: 1.96-8.26. Up to 40% of those with GAD had at least another diagnosis of mood, anxiety, or eating disorders. The mean score of SF-12 in people with GAD was 32.33 ± 6.8, with a higher attributable burden than in other conditions except for major depressive disorder.
We found a relatively lower lifetime prevalence of GAD than in community surveys based on lay interviewers and a structured interview. The identified cases of GAD showed a strong impact on the quality of life regardless of co-morbidity and high risk in women, suggesting a profile similar to the one identified from studies in primary and specialized care.
广泛性焦虑障碍(GAD)是精神病学中报告最多的诊断之一,但社区研究中确定的病例与三级保健中确定的病例之间存在一些差异。本研究旨在评估临床医生作为访谈者是否可以在社区调查中提供接近初级或专科护理观察到的估计值。
这是一项针对随机抽取的 2338 名成年受试者的社区调查。使用临床医生进行高级神经精神工具和评估时间表(ANTAS),根据 DSM-IV-TR 提供终生诊断。使用健康相关生活质量量表(SF-12)测量健康相关生活质量(HR-QoL)。
总体而言,55 名(2.3%)受试者符合 GAD 标准,女性(3.6%)患病率高于男性(0.9%):OR=4.02;95%CI:1.96-8.26。高达 40%的 GAD 患者至少还有另一种心境、焦虑或饮食障碍的诊断。患有 GAD 的人的 SF-12 平均得分为 32.33±6.8,其归因负担高于其他疾病,除了重度抑郁症。
我们发现,与基于非专业访谈者和结构化访谈的社区调查相比,GAD 的终生患病率相对较低。确定的 GAD 病例无论共病和女性高风险如何,对生活质量都有很大影响,这表明其与初级和专科护理研究中确定的 GAD 相似。