Skip to main content Accessibility help
×
Home

Rethinking the duration requirement for generalized anxiety disorder: evidence from the National Comorbidity Survey Replication

  • RONALD C. KESSLER (a1), NANCY BRANDENBURG (a2), MICHAEL LANE (a1), PETER ROY-BYRNE (a3), PAUL D. STANG (a4), DAN J. STEIN (a5) and HANS-ULRICH WITTCHEN (a6)...

Abstract

Background. The proposed revisions of the ICD and DSM diagnostic systems have led to increased interest in evaluation of diagnostic criteria. This report focuses on the DSM-IV requirement that episodes of generalized anxiety disorder (GAD) must persist for at least 6 months. Community epidemiological data are used to study the implications of changing this requirement in the range 1–12 months for estimates of prevalence, onset, course, impairment, co-morbidity, associations with parental GAD, and sociodemographic correlates.

Method. Data come from the US National Comorbidity Survey Replication (NCS-R), a US household survey carried out during 2001–2003. Version 3.0 of the WHO Composite International Diagnostic Interview (WMH-CIDI) was used to assess DSM-IV anxiety disorders, mood disorders, substance disorders, and impulse-control disorders.

Results. Lifetime, 12-month, and 30-day prevalence estimates of DSM-IV GAD changed from 6·1%, 2·9%, and 1·8% to 4·2–12·7%, 2·2–5·5%, and 1·6–2·6% when the duration requirement was changed from 6 months to 1–12 months. Cases with episodes of 1–5 months did not differ greatly from those with episodes of [ges ]6 months in onset, persistence, impairment, co-morbidity, parental GAD, or sociodemographic correlates.

Conclusions. A large number of people suffer from a GAD-like syndrome with episodes of <6 months duration. Little basis for excluding these people from a diagnosis is found in the associations examined here.

Copyright

Corresponding author

Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, USA 02115. (Email: kessler@hcp.med.harvard.edu)

Footnotes

Hide All
The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or U.S. Government.

Footnotes

Type Description Title
PDF

Kessler supplementary material
Appendix 1-4

 PDF (54 KB)
54 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed