Modifying Duration Criterion in Generalized Anxiety Disorder: Effects on Prevalence and Disability in an Asian Community Sample

Abstract:

The 6-month duration requirement of generalized anxiety disorder (GAD) diagnosis has been contentious since its introduction. The current study examined the effects of modifying the duration requirement in diagnosing GAD to 1 month, 3 months, and 12 months, on the prevalence, associated impairments, and comorbidity. Data was derived from The Singapore Mental Health Study (SMHS). SMHS was a nationwide epidemiological study conducted on 6,616 Singapore adult residents. The Composite International Diagnostic Interview (CIDI v3.0) was used to establish the diagnoses of mental disorders. Lifetime prevalence of GAD was 2.44%, 1.64%, 1.23%, and 0.81% when the duration requirement was at 1 month, 3 months, 6 months, and 12 months. The 6-month duration criterion in GAD did not differentiate GAD cases with impaired functioning and comorbidity. GAD cases with less than 6 month duration also suffered from disability. Substantial numbers of individuals who suffered from pathological anxiety, however did not receive a GAD diagnosis, largely because they failed to meet the 6-month duration criterion. Future investigation is needed to examine the diagnostic validity of the duration requirement of GAD.

Keywords::

• epidemiology
• population based survey
• mental disorder
• Composite International Diagnostic Interview
• Asians