RESEARCH ARTICLE


Broadening of Generalized Anxiety Disorders Definition Does not Affect the Response to Psychiatric Care: Findings from the Observational ADAN Study



Enrique Álvarez1, Jose L Carrasco2, José M Olivares3, Vanessa López-Gómez4, Inma Vilardaga5, María Perez4, *
1 Department of Psychiatry, Hospital de la Santa Creu i San Pau, Barcelona, Spain
2 2Department of Psychiatry, Hospital Clínico San Carlos, Madrid, Spain
3 Department of Psychiatry, Hospital Meixoeiro, Complejo Hospitalario Universitario, Vigo, Spain
4 Medical Unit, Pfizer Spain, Alcobendas (Madrid), Spain
5 Department of Biometric and Statistic, European Biometric Institute, Barcelona, Spain


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© Álvarez et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Avda. de Europa, 20 B Parque Empresarial La Moraleja 28108 Alcobendas (Madrid); E-mail: maria.perez2@pfizer.com


Abstract

Objective:

To elucidate the consequences of broadening DSM-IV criteria for generalized anxiety disorder (GAD), we examined prospectively the evolution of GAD symptoms in two groups of patients; one group diagnosed according to DSM-IV criteria and the other, according to broader criteria.

Method:

Multicentre, prospective and observational study conducted on outpatient psychiatric clinics. Patients were selected from October 2007 to January 2009 and diagnosed with GAD according to DSM-IV criteria (DSM-IV group) or broader criteria. Broader criteria were considered 1-month of excessive or non-excessive worry and only 2 of the associated symptoms listed on DSM-IV for GAD diagnosis. Socio-demographic data, medical history and functional outcome measures were collected three times during a 6-month period.

Results:

3,549 patients were systematically recruited; 1,815 patients in DSM-IV group (DG) and 1,264 in broad group (BG); 453 patients did not fulfil inclusion criteria and were excluded. Most patients (87.9% in DG, 82.0% in BG) were currently following pharmacological therapies (mainly benzodiazepines) to manage their anxiety symptoms. The changes observed during the study were: 49.0% and 58.0%, respectively of patients without anxiety symptoms as per HAM-A scale at the 6 month visit (p=0.261) and 59.7% and 67.7%, respectively (p=0.103) of responder rates (> 50% reduction of baseline scoring).

Conclusion:

Broadening of GAD criteria does not seem to affect psychiatric care results in subjects with GAD, is able to identify the core symptoms of the disease according to the DSM-IV criteria and could lead to an earlier diagnosis.

Keywords: Diagnostic and Statistical Manual of Mental Disorders, Generalized anxiety disorder, Hamilton Anxiety Rating Scale, Self-reported quality of life.