Generalized anxiety disorder (GAD) is a highly prevalent distressing condition for individuals in both community and community primary care settings. However, despite the high prevalence of GAD identified in epidemiological studies, little is known about GAD and its related symptoms and impairments in veteran populations. The present study investigated the prevalence, comorbidity, physical and mental health impairment, and healthcare utilization of veteran participants with GAD, as well as comparing symptoms of GAD and posttraumatic stress disorder (PTSD). Veterans (N=884) participated in a cross-sectional investigation in primary care clinics in four Veteran Affairs Medical Centers (VAMCs) and completed diagnostic interviews and self-report questionnaires; a chart review was conducted to assess their VAMC healthcare utilization. A large number of participants (12%) met diagnostic criteria for GAD, reporting significantly worse emotional health, pain, and general health, in addition to increased mental healthcare utilization and antidepressant medications. In addition, GAD was found in 40% of participants with PTSD, resulting in more severe symptoms and impairment than in patients with GAD alone. These findings provide evidence of high prevalence and severe impairment associated with GAD in veterans and highlight the need for improved recognition, assessment, and treatments for GAD.
Generalized anxiety disorder (GAD), an anxiety disorder characterized by persistent and uncontrollable anxiety and worry, is associated with high financial costs and primary care utilization (Marsland et al., 1976, Greenberg et al., 1999, Roemer et al., 2002 and Kroenke et al., 2007). GAD also results in significant impairment, including increased problems in occupational (e.g., frequency of absence and work productivity), social (e.g., social network and family), and physical health (e.g., chest pain and irritable bowel syndrome) functioning (Wittchen and Hoyer, 2001 and Roemer et al., 2002). The prevalence of GAD has been found in 1.6–3.5% of individuals in community samples (Roemer et al., 2002). However, GAD has been shown to be found in 7.6% of patients in civilian primary care settings, suggesting a possible link between the symptoms of GAD and increased utilization of health care (Kessler et al., 2005 and Kroenke et al., 2007).
Interestingly, little is known regarding the prevalence of GAD in veteran primary care settings. In general, the few studies examining GAD in combat veteran populations have found elevated rates of GAD, with 9.7% of Vietnam veterans and up to 15% of Iraq and Afghanistan veterans reporting symptoms consistent with GAD (Hoge et al., 2004 and Phillips et al., 2009). Although dated, similar findings have been demonstrated in non-combat veterans (Jordan et al., 1991). Together, these findings suggest that veterans may be at greater risk for developing GAD.
