Generalized anxiety disorder: Nature and course

Generalized anxiety disorder (GAD) is a chronic and highly prevalent disord er in the adult population, yet it remains a relatively poorly understood c ondition. Clinicians may be familiar with the symptoms of enduring excessiv e worrying, anxiety, and hypervigilance that are characteristic of GAD. but may not necessarily recognize that these are usually symptoms of a distinc t psychiatric disorder. Despite changes in diagnostic criteria, estimates o f prevalence for GAD are remarkably consistent across epidemiologic studies . Lifetime prevalence in the general population is estimated at 5% (DSM-III and/or DSM-III-R criteria), with rates as high as 10% among women aged 40 years and above, and cross-sectional rates among primary care attenders are about 8%, making GAD the most prevalent anxiety disorder in primary care. The age at onset of GAD differs from that of other anxiety disorders: preva lence rates are low in adolescents and young adults but increase substantia lly with age. Females are at greater risk than males, and the disorder is c orrelated with being unemployed or a housewife or having a chronic medical illness. GAD is frequently associated with comorbid depression and other an xiety and somatoform disorders. Significant CAD-specific disability occurs even when comorbidity is not present.