Disabilities and quality of life in pure and comorbid generalized anxiety disorder and major depression in a national survey

Using a nationally representative sample, this study examines the disease-s pecific impairments of DSM-IV generalized anxiety disorder (GAD) by compari ng them to the impairments associated with major depressive disorder (MDD). Results are based on 4181 respondents between the ages of 18-65 years who were interviewed with the 12-month version of the Munich-Composite Internat ional Diagnostic Interview as part of the German National Health Interview and Examination Survey-Mental Health Supplement (GHS). After controlling fo r age, gender, and other psychopathology, 'pure' current GAD without MDD (n = 33), pure MDD (n = 344) and comorbid GAD and MDD (n = 40) were each asso ciated with high impairment as defined by poor self-perceived health, at le ast 3 days limited or impaired in the past month, and low quality of life s cores [from the Short Form-36 Health Survey (SF-36)]. Quality of life score s on several of the SF-36 scales n ere significantly lower for respondents with pure GAD as compared to respondents,vith pure MDD. Overall, the result s show that DSM-IV GAD is associated with high impairment even after contro lling for other psychopathology. The impairment outcomes for GAD were compa rable in size to those for MDD. These findings underline the significance o f this disorder from a clinical and social perspective and provide support for the independent diagnostic status Of GAD. (C) 2000 Lippincott Williams & Wilkins.