Incidence Of Generalized Anxiety Disorder Research Articles

A longitudinal investigation of marital dissolution, marital quality, and generalized anxiety disorder in a national probability sample

Generalized anxiety disorder (GAD) is a common psychiatric disorder that is associated with high levels of distress and impairment. The present study was conducted to examine the 10-year longitudinal associations between marital dissolution, three measures of marital quality, and GAD among married participants from the Midlife in the United States (MIDUS) survey, a probability sample of American adults aged 24–74 years. Results indicated that GAD at baseline was significantly and positively associated with incidence of marital dissolution during the 10-year follow-up and marital strain (i.e., negative partner interaction) at baseline was significantly and positively associated with incidence of GAD at the 10-year follow-up. These associations remained statistically significant after adjusting for demographic characteristics and neuroticism. In comparison, marital satisfaction and marital support (i.e., positive partner interaction) at baseline were not significantly associated with incidence of GAD, GAD at baseline was not significantly associated with any of the three measures of marital quality at follow-up, and marital dissolution during follow-up was not significantly associated with incidence of GAD. These findings suggest that negative interactions with one’s partner may be a risk factor for GAD and that improving marital functioning may be important for the prevention and treatment of GAD.

Trajectories of generalized anxiety disorder, major depression and change in quality of life in adults aged 50 + : findings from a longitudinal analysis using representative, population-based data from Ireland

PurposeTo investigate the longitudinal association between trajectories (incidence, remission) of generalized anxiety disorder (GAD), major depression (MD) and change in quality of life (QoL) in adults aged 50 + , and to assess the symmetry in these relationships using observational study data.MethodsData were derived from two waves of The Irish Longitudinal Study on Aging (2014–2015, wave 3: n = 6400; 2016, wave 4: n = 5715), a nationally representative cohort of community-dwelling adults aged 50 +. GAD and MD were assessed by means of the short form of the Composite International Diagnostic Interview. QoL outcomes were assessed using the Control, Autonomy, Self-realization, and Pleasure scale (CASP-12 with two domains control/autonomy and self-realization/pleasure). Covariate-adjusted, asymmetric fixed effects panel regressions and post-estimation Wald tests were used for statistical analysis.ResultsRegarding incident disorders, only incident MD was significantly associated with a reduction in QoL over time (control/autonomy domain: b = − 0.74, SE: 0.30). Regarding remission, both remission of MD (b = 0.61, SE: 0.20) and remission of GAD (b = 0.61, 0.26) were significantly associated with an increase in the self-realization/pleasure domain over time. Subsequent Wald tests of the estimates were not significant, indicating symmetric effects.ConclusionParticularly the remission of GAD and MD was associated with a significant improvement in one of the QoL domains, indicating domain- and trajectory-specific differences. However, symmetric effects observed in this study indicate that gains and losses in QoL associated with remission and incidence of GAD and MD are of similar magnitude in adults aged 50 +.

Maternal smoking during pregnancy and children's mental health at age 22 years: Results of a birth cohort study

BackgroundEarly exposures such as maternal smoking can be associated mental disorders. We aimed to analyze the association between maternal smoking during pregnancy (MSDP), generalized anxiety disorder (GAD), and depression in the 1993 birth cohort (Pelotas, Brazil). MethodsData on maternal smoking were collected in the perinatal study, while information on GAD and depression was collected at age 22 years using the Mini International Neuropsychiatric Interview (MINI). Information on maternal mental health, the mediator, was collected at the 11-year follow-up. Simple and multiple logistic regressions were used to assess the association between exposure, outcomes, and analysis of negative controls. Results3,781 participants presented complete data. The incidence of GAD was 10.4%, depression 2.9%, and smoking during pregnancy 32.6%. The children of mothers who smoked had a 45% higher chance of developing GAD at age 22 years (OR 1.45; 95%CI 1.18; 1.80) and 75% higher chance of depression (OR 1.75; 95%CI 1.18; 2.59). Also, the higher the number of cigarettes smoked. the higher was the chance for the development of GAD. Paternal smoking was not associated with the outcomes. The mother's mental health accounted for 18.2% of the association between maternal smoking and GAD, and for 13.4% for maternal smoking and depression. LimitationsData for smoking during pregnancy were collected through a self-report. Residual confusion due to important variables cannot be ruled out. ConclusionsMSDP was associated with the mental health of children in early adulthood. However, a small part of the effect found was mediated by the mother's mental health.

Epidemiology and prognostic implications of panic disorder and generalized anxiety disorder in patients with coronary artery disease: rationale and design for a longitudinal cohort study

BackgroundAnxiety is associated with poorer prognosis in patients with coronary artery disease (CAD). Due to their severity and chronic course, anxiety disorders, particularly generalized anxiety disorder (GAD) and panic disorder (PD), are of considerable interest and clinical importance in this population. This study has two main objectives: (1) to estimate the prevalence and incidence of GAD and PD in patients with CAD over a 2-year period and (2) to prospectively assess the association between PD or GAD and adverse cardiac events, treatment adherence, CAD-related health behaviors, quality of life and psychological distress.Design/MethodThis is a longitudinal cohort study in which 3610 participants will be recruited following a CAD-related revascularization procedure. They will complete an interview and questionnaires at 5 time points over a 2-year period (baseline and follow-ups after 3, 6, 12 and 24 months). The presence of PD or GAD, adherence to recommended treatments, health behaviors, quality of life and psychological distress will be assessed at each time point. Data regarding mortality and adverse cardiac events will be collected with a combination of interviews and review of medical files.DiscussionThis study will provide essential information on the prevalence and incidence of anxiety disorders in patients with CAD and on the consequences of these comorbidities. Such data is necessary in order to develop clear clinical recommendations for the management of PD and GAD in patients with CAD. This will help improve the prognosis of patients suffering from both conditions.

Physical activity partially mediates associations between “Big” personality traits and incident generalized anxiety disorder: Findings from the irish longitudinal study on ageing

Background: This study aimed to examine associations of personality with generalized anxiety disorder (GAD) and physical activity (PA), PA with GAD, and PA mediates associations between personality and incident GAD.Methods: Participants aged ≥50 years completed the 60-item NEO-Five Factor Inventory questionnaire to assess personality and short-form International Physical Activity Questionnaire at baseline, and the Composite International Diagnostic Interview – Short Form to clinically assess GAD at baseline and 2, 4, and 6 years later. Participants who had GAD at baseline or reported having ever been told by a doctor that they had anxiety were excluded from analyses. Binary logistic regression quantified associations of the ‘Big Five’ personality traits with PA and incident GAD, and associations of PA with incident GAD (i.e., GAD at any point during follow-up). The ‘counterfactual approach’ identified potential mediating effects of PA in the associations between personality traits and incident GAD.Results: Participants (n = 4582; 53.7% female) were aged 64.38±8.88 years. Incidence of GAD was 2.95% (n = 135). Extraversion (OR=1.160, 95%CI=1.087–1.237), openness (1.113, 1.043–1.188), and conscientiousness (1.083, 1.015–1.155) were positively associated with physical activity. Neuroticism was positively (2.335, 1.945–2.803), and extraversion (0.700, 0.563–0.797), conscientiousness (0.826, 0.693–0.985), and PA (0.655, 0.451–0.952) were inversely, associated with the incident GAD. Approximately 8.7% of the effect of extraversion and 8.8% of the effect of conscientiousness on GAD was due to mediation by PA only.Limitations: PA was self-reportedConclusions: Personality screening may help to identify older adults at-risk of anxiety who would benefit from participation in physical activity interventions.

Walking Away Depression And Anxiety: Results From The Irish Longitudinal Study On Ageing

Walking is an accessible physical activity that is promoted as a best buy for public health. However, few prospective studies have examined the association between walking and depression, and none have investigated Generalized Anxiety Disorder (GAD). PURPOSE: This study examined associations between walking and incident depression and incident GAD among community-dwelling adults aged ≥50 years in the Republic of Ireland. METHODS: Participants completed the short form International Physical Activity Questionnaire at baseline and Center for Epidemiological Studies Depression Scale (CES-D) and CIDI-short form at two-year follow-up. Walking doses were categorised based on reported minutes of walking in the prior seven days (None=0 minutes/week; Low=1-209 minutes/week; Moderate=210-419 minutes/week; High=420+ minutes/week). Logistic regression, weighted relative to age, sex, and education and adjusted for age, sex, waist circumference, social class, smoking, moderate and vigorous physical activity, comorbidities, and physical limitations, quantified associations between walking and incident depression (N=4,146; 55.4% female) and GAD (N=3,326; 52.6% female) in participants without depression (CES-D≥16) or GAD (abbreviated Penn State Worry Questionnaire ≥23) at baseline. Likelihood ratio tests examined covariate significance. RESULTS: Incidence of depression and GAD were 5.0% (n=207) and 0.9% (n=29), respectively. Compared to people who reported no walking, odds (odds ratio, 95% confidence interval) of incident depression were lower among those engaging in Low (0.908, 0.876-0.940; p<0.001), Moderate (0.893, 0.858-0.929; p<0.001), and High (0.897, 0.865-0.931; p<0.001) walking doses. Odds of incident GAD were also lower among those engaging in Low (0.411, 0.335-0.406; p<0.001), Moderate (0.710, 0.6432-0.786; p<0.001), and High (0.614, 0.555-0.678; p<0.001) walking doses. All covariates significantly contributed to the models (p<0.001). CONCLUSION: Among a large, nationally representative sample of older adults, self-reported walking was associated with lower odds of incident depression and GAD independent of moderate and vigorous intensity physical activity. These findings support policy and national guidelines in promoting walking for its mental health benefits.

Associations between grip strength and generalized anxiety disorder in older adults: Results from the Irish longitudinal study on ageing

BackgroundAssociations between grip strength and mental health disorders have been established; however, associations between grip strength and Generalized Anxiety Disorder (GAD) remain unstudied. Therefore, this study investigates associations between grip strength and prevalent and incident GAD. MethodsA prospective cohort design was utilized. At baseline, participants aged ≥50 years (N = 3,952) completed a hand grip strength assessment and abbreviated Penn State Worry Questionnaire (PSWQ) and were divided into sex-specific tertiles based on strength. A score of ≥23 on the PSWQ defined caseness of GAD. At two-year follow-up, GAD was assessed with the Composite International Diagnostic Interview—Short Form. ResultsPrevalence and incidence of GAD were 18.2% (N = 718) and 0.9% (N = 29), respectively. Adjusting for age, sex, waist circumference, social class, smoking status, and physical activity, a one-standard-deviation (1-SD) increase in strength was associated (OR, 95%CI) with 12.1% (OR = 0.88, 0.80–0.96; p < 0.01) lower odds of prevalent GAD, and middle and high strength tertiles were associated with 27.3% (OR = 0.73, 0.59–0.89; p < 0.01) and 23.1% (OR = 0.77, 0.62–0.95; p < 0.05) lower odds, respectively. A 1-SD increase in strength was non-significantly associated with 24.2% (OR = 0.76, 0.50–1.14) lower odds of incident GAD, and middle and high strength tertiles were non-significantly associated with 31.4% (OR = 0.69, 0.30–1.58) and 66.5% (OR = 0.34, 0.11–1.00) lower odds, respectively (all p > 0.05). There was no significant interaction between strength tertiles and sex. LimitationsThe observational nature of the study limits inferring causality. ConclusionsIncreased hand grip strength may be associated with lower odds of developing GAD in older adults. Larger investigations of prospective associations are needed.

Physical activity and generalized anxiety disorder: results from The Irish Longitudinal Study on Ageing (TILDA).

Generalized anxiety disorder (GAD) is prevalent and costly. Physical activity (PA) may protect against other mental health disorders, including depression, but its protective effect on GAD remains under-studied in the general population and unstudied among older adults. Therefore, the present study examines associations between meeting World Health Organization PA guidelines (i.e. ≥150 min of moderate PA, ≥75 min of vigorous PA or ≥600MET min of moderate and vigorous PA weekly) and the prevalence of probable GAD and incidence of GAD. Participants (n = 3950; 56.2% female) aged ≥50 years completed the short-form International Physical Activity Questionnaire and the abbreviated Penn State Worry Questionnaire at baseline and the Composite International Diagnostic Interview - Short Form to clinically assess GAD 2 years later. Prospective analyses included participants without probable GAD at baseline (n = 3236). Prevalence and incidence of GAD were 18.1% (n = 714) and 0.9% (n = 29), respectively. More respondents with GAD were female (72.2% vs 52.7%), aged 50-59 years (51.7% vs 38.7%), had normal waist circumference (52.7% vs 47.8) and smoked (20.4% vs 13.3%; all P <0.05). Meeting PA guidelines was associated with 25% and 63% lower odds of prevalent [odds ratio (OR) = 0.75, 95% confidence interval: 0.64 to 0.88] and incident (OR = 0.37, 0.17 to 0.85) GAD, respectively, in crude models, and 17% and 57% lower odds of prevalent (OR = 0.83, 0.70 to 0.98) and incident (OR = 0.43, 0.19 to 0.99) GAD, respectively, following adjustment for age, sex, waist circumference, social class and smoking. In addition to established physical health benefits of PA, the present findings support the importance of increasing PA at the population-level for mental health.

The Feasibility, Acceptability, and Efficacy of Delivering Internet-Based Self-Help and Guided Self-Help Interventions for Generalized Anxiety Disorder to Indian University Students: Design of a Randomized Controlled Trial.

BackgroundGeneralized anxiety disorder (GAD) is one of the most common mental disorders among university students; however, many students go untreated due to treatment costs, stigma concerns, and limited access to trained mental health professionals. These barriers are heightened in universities in India, where there are scant mental health care services and severe stigma surrounding help seeking.ObjectiveTo evaluate the feasibility, acceptability, and efficacy of Internet-based, or “online,” cognitive behavioral therapy (CBT)-based unguided and guided self-help interventions (using the programs GAD Online and Lantern, respectively) to reduce GAD symptoms in students with clinical and subthreshold GAD and, ultimately, reduce the prevalence and incidence of GAD among the student population.MethodsStudents will be recruited via 3 colleges in Hyderabad, India, and referred for a campus-wide online screening. Self-report data will be collected entirely online. A total of 300 qualifying students will be randomized in a 1:1:1 ratio to receive GAD Online, Lantern, or to be in a wait-list control condition, stratified by clinical and subthreshold GAD symptomatology. Students will complete a postintervention assessment after 3 months and a follow-up assessment 6 months later, at which point students in the wait-list control condition will receive one of the programs. The primary outcome is GAD symptom severity at 3 months postintervention. Secondary outcomes include GAD caseness at 9 months, other anxiety and depression symptoms, self-efficacy, and functional measures (eg, sleep, social functioning) at 3 and 9 months, respectively. Primary analyses will be differences between each of the intervention groups and the wait-list control group, analyzed on an intention-to-treat (ITT) basis using mixed-design ANOVA.ResultsThe study commenced in February 2015. The sample was recruited over a 3-week period at each college. The trial is expected to end in December 2015.ConclusionsThis trial will be the first to evaluate the use of Internet-based CBT programs compared with a wait-list control group for the treatment of GAD among students in Indian universities. If effective, these programs have the potential to reduce the mental health care treatment gap by providing readily accessible, private, and cost-effective evidence-based care to students with GAD who do not currently receive the treatment they need.Trial RegistrationClinicalTrials.gov NCT02410265 http://clinicaltrials.gov/ct2/show/NCT02410265 (Archived by WebCite at http://www.webcitation.org/6ddqH6Rbt).

Risk factors for late-onset generalized anxiety disorder: results from a 12-year prospective cohort (the ESPRIT study).

Generalized anxiety disorder (GAD) is a chronic and highly prevalent disorder associated with increased disability and mortality in the elderly. Treatment is difficult with low rate of full remission, thus highlighting the need to identify early predictors for prevention in elderly people. The aim of this study is to identify and characterize incident GAD predictors in elderly people. A total of 1711 individuals aged 65 years and above and free of GAD at baseline were randomly recruited from electoral rolls between 1999 and 2001 (the prospective ESPRIT study). The participants were examined at baseline and five times over 12 years. GAD and psychiatric comorbidity were diagnosed with a standardized psychiatric examination, the Mini-International Neuropsychiatry Interview on the basis of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) criteria and validated by a clinical panel. During the follow-up, 8.4% (95% confidence interval=7.1–9.7%) of the participants experienced incident GAD, 80% being first episodes; the incident rate being 10 per 1000 person-years. The principal predictors of late-onset incident GAD over 12 years derived from a multivariate Cox model were being female, recent adverse life events, having chronic physical (respiratory disorders, arrhythmia and heart failure, dyslipidemia, cognitive impairment) and mental (depression, phobia and past GAD) health disorders. Poverty, parental loss or separation and low affective support during childhood, as well as history of mental problems in parents were also significantly and independently associated with incident GAD. GAD appears as a multifactorial stress-related affective disorder resulting from both proximal and distal risk factors, some of them being potentially modifiable by health care intervention.