Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Verily Life Sciences (Alphabet), San Francisco, CA, USA.
J Affect Disord. 2022 Nov 15;317:287-297. doi: 10.1016/j.jad.2022.08.085. Epub 2022 Aug 27.
The General Anxiety Disorder-7 (GAD-7) questionnaire is a standard tool used for screening and follow-up of patients with Generalized Anxiety Disorder (GAD). Although it is generally accepted that anxiety correlates with clinical and psychosocial stressors, precise quantitative data is limited on the relations among GAD-7, traditional biomarkers, and other measures of health. Further research is needed about how GAD-7 relates to race, ethnicity, and socioeconomic status (SES) as an assembly. We determined how multiple demographic and socioeconomic data correlate with the participants' GAD-7 results when compared with laboratory, physical function, clinical, and other biological markers.
The Project Baseline Health Study (BHS) is a prospective cohort of adults representing several populations in the USA. We analyzed a deeply phenotyped group of 2502 participants from that study. Measures of interest included: clinical markers or history of medical diagnoses; physical function markers including gait, grip strength, balance time, daily steps, and echocardiographic parameters; psychometric measurements; activities of daily living; socioeconomic characteristics; and laboratory results.
Higher GAD-7 scores were associated with female sex, younger age, and Hispanic ethnicity. Measures of low SES were also associated with higher scores, including unemployment, income ≤$25,000, and ≤12 years of education. After adjustment for 158 demographic, clinical, laboratory, and symptom characteristics, unemployment and overall higher SES risk scores were highly correlated with anxiety scores. Protective factors included Black race and older age.
Correlations identified in this cross-sectional study cannot be used to infer causal relationships; further, we were not able to account for possible use of anxiety treatments by study participants.
These findings highlight the importance of understanding anxiety as a biopsychosocial entity. Clinicians and provider organizations need to consider both the physical manifestations of the disorder and their patients' social determinants of health when considering treatment pathways and designing interventions.
广泛性焦虑障碍-7 项（GAD-7）问卷是一种用于筛查和随访广泛性焦虑障碍（GAD）患者的标准工具。尽管人们普遍认为焦虑与临床和心理社会压力因素有关，但关于 GAD-7 与传统生物标志物以及其他健康指标之间的关系的精确定量数据有限。需要进一步研究 GAD-7 与种族、民族和社会经济地位（SES）之间的关系。我们确定了当与实验室、身体功能、临床和其他生物标志物相比时，参与者的 GAD-7 结果与多个人口统计学和社会经济数据之间的相关性。
项目基线健康研究（BHS）是一项代表美国多个人群的前瞻性队列研究。我们分析了该研究中 2502 名参与者的深度表型组。感兴趣的测量指标包括：临床标志物或医疗诊断史；身体功能标志物，包括步态、握力、平衡时间、每日步数和超声心动图参数；心理测量学测量；日常生活活动；社会经济特征；和实验室结果。
较高的 GAD-7 评分与女性、年轻和西班牙裔有关。低 SES 措施也与较高的评分相关，包括失业、收入≤25,000 美元和≤12 年教育程度。在调整了 158 项人口统计学、临床、实验室和症状特征后，失业和整体较高 SES 风险评分与焦虑评分高度相关。保护因素包括黑人种族和年龄较大。
本横断面研究中确定的相关性不能用于推断因果关系；此外，我们无法解释研究参与者可能使用的焦虑治疗方法。
这些发现强调了理解焦虑作为一种生物心理社会实体的重要性。临床医生和提供者组织在考虑治疗途径和设计干预措施时，需要考虑到该疾病的身体表现及其患者的健康社会决定因素。
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