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Title: Implications of modifying the duration requirement of generalized anxiety disorder in developed and developing countries
Authors: Lee, S. ×
Tsang, A.
Ruscio, A. M.
Haro, J. M.
Stein, D. J.
Alonso, J.
Angermeyer, M. C.
Bromet, E. J.
Demyttenaere, Koen
de Girolamo, G.
de Graaf, R.
Gureje, O.
Iwata, N.
Karam, E. G.
Lepine, J-P.
Levinson, D.
Medina-Mora, M. E.
Oakley Browne, M. A.
Posada-Villa, J.
Kessler, R. C. #
Issue Date: Jul-2009
Publisher: Cambridge University Press
Series Title: Psychological Medicine vol:39 issue:7 pages:1163-1176
Abstract: BACKGROUND: A number of western studies have suggested that the 6-month duration requirement of generalized anxiety disorder (GAD) does not represent a critical threshold in terms of onset, course, or risk factors of the disorder. No study has examined the consequences of modifying the duration requirement across a wide range of correlates in both developed and developing countries. METHOD: Population surveys were carried out in seven developing and 10 developed countries using the WHO Composite International Diagnostic Interview (total sample=85,052). Prevalence and correlates of GAD were compared across mutually exclusive GAD subgroups defined by different minimum duration criteria. RESULTS: Lifetime prevalence estimates for GAD lasting 1 month, 3 months, 6 months and 12 months were 7.5%, 5.2%, 4.1% and 3.0% for developed countries and 2.7%, 1.8%, 1.5% and 1.2% for developing countries, respectively. There was little difference between GAD of 6 months' duration and GAD of shorter durations (1-2 months, 3-5 months) in age of onset, symptom severity or persistence, co-morbidity or impairment. GAD lasting >or=12 months was the most severe, persistently symptomatic and impaired subgroup. CONCLUSIONS: In both developed and developing countries, the clinical profile of GAD is similar regardless of duration. The DSM-IV 6-month duration criterion excludes a large number of individuals who present with shorter generalized anxiety episodes which may be recurrent, impairing and contributory to treatment-seeking. Future iterations of the DSM and ICD should consider modifying the 6-month duration criterion so as to better capture the diversity of clinically salient anxiety presentations.
URI: 
ISSN: 0033-2917
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Research Group Psychiatry
× corresponding author
# (joint) last author

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