Generalized anxiety disorder (ICD-10) in primary care from a cross-cultural perspective: a valid diagnostic entity?
Version of Record online: 11 NOV 2009
Acta Psychiatrica Scandinavica
Volume 101, Issue 1, pages 29–36, January 2000
How to Cite
Maier, W., Gänsicke, M., Freyberger, H. J., Linz, M., Heun, R. and Lecrubier, Y. (2000), Generalized anxiety disorder (ICD-10) in primary care from a cross-cultural perspective: a valid diagnostic entity?. Acta Psychiatrica Scandinavica, 101: 29–36. doi: 10.1034/j.1600-0447.2000.101001029.x
- Issue online: 11 NOV 2009
- Version of Record online: 11 NOV 2009
- Accepted for publication May 17, 1999
- Cited By
- generalized anxiety disorder;
- primary care
Objective:Generalized anxiety disorder (GAD) is a common psychiatric disorder. The nosological status of this diagnostic entity was critically discussed because of the very high rate of comorbidity with other psychiatric disorders, the assumed low degree of social disability associated with GAD in the absence of other disorders, and an ambigious definition.
Method:We explored the frequency and associated social disability of GAD, and examined whether the ICD-10 definition of GAD is appropriate. The analysis was based on the WHO study on ‘Psychological Problems in Primary Care’ conducted in a standardized manner in 14 countries.
Results:We found GAD (total and without another psychiatric disorder) to be common in primary care in nearly all countries (mean 1-month prevalence rate, 7.9%), with 25% of these cases presenting with GAD in the absence of any comorbid psychiatric disorder. GAD in general, as well as non-comorbid GAD, are associated with social disability which is as severe as that in chronic somatic diseases.
Conclusion:It remains questionable whether the current ICD-10 diagnosis of GAD defining 6 months as a minimum duration and requiring at least four associated symptoms for diagnosis is the most appropriate option. Using this definition, a substantial proportion of psychosocially disabled subjects characterized by anxiety, tension and worrying remain undetected, and are possibly therefore not adequately treated.