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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Cross-sectional Comparison of the Epidemiology of <italic>DSM-5</italic> Generalized Anxiety Disorder Across the Globe</title><author><name sortKey="Ruscio, Ayelet Meron" sort="Ruscio, Ayelet Meron" uniqKey="Ruscio A" first="Ayelet Meron" last="Ruscio">Ayelet Meron Ruscio</name></author><author><name sortKey="Hallion, Lauren S" sort="Hallion, Lauren S" uniqKey="Hallion L" first="Lauren S." last="Hallion">Lauren S. Hallion</name></author><author><name sortKey="Lim, Carmen C W" sort="Lim, Carmen C W" uniqKey="Lim C" first="Carmen C. W." last="Lim">Carmen C. W. Lim</name></author><author><name sortKey="Aguilar Gaxiola, Sergio" sort="Aguilar Gaxiola, Sergio" uniqKey="Aguilar Gaxiola S" first="Sergio" last="Aguilar-Gaxiola">Sergio Aguilar-Gaxiola</name></author><author><name sortKey="Al Hamzawi, Ali" sort="Al Hamzawi, Ali" uniqKey="Al Hamzawi A" first="Ali" last="Al-Hamzawi">Ali Al-Hamzawi</name></author><author><name sortKey="Alonso, Jordi" sort="Alonso, Jordi" uniqKey="Alonso J" first="Jordi" last="Alonso">Jordi Alonso</name></author><author><name sortKey="Andrade, Laura Helena" sort="Andrade, Laura Helena" uniqKey="Andrade L" first="Laura Helena" last="Andrade">Laura Helena Andrade</name></author><author><name sortKey="Borges, Guilherme" sort="Borges, Guilherme" uniqKey="Borges G" first="Guilherme" last="Borges">Guilherme Borges</name></author><author><name sortKey="Bromet, Evelyn J" sort="Bromet, Evelyn J" uniqKey="Bromet E" first="Evelyn J." last="Bromet">Evelyn J. Bromet</name></author><author><name sortKey="Bunting, Brendan" sort="Bunting, Brendan" uniqKey="Bunting B" first="Brendan" last="Bunting">Brendan Bunting</name></author><author><name sortKey="De Almeida, Jose Miguel Caldas" sort="De Almeida, Jose Miguel Caldas" uniqKey="De Almeida J" first="José Miguel Caldas" last="De Almeida">José Miguel Caldas De Almeida</name></author><author><name sortKey="Demyttenaere, Koen" sort="Demyttenaere, Koen" uniqKey="Demyttenaere K" first="Koen" last="Demyttenaere">Koen Demyttenaere</name></author><author><name sortKey="Florescu, Silvia" sort="Florescu, Silvia" uniqKey="Florescu S" first="Silvia" last="Florescu">Silvia Florescu</name></author><author><name sortKey="De Girolamo, Giovanni" sort="De Girolamo, Giovanni" uniqKey="De Girolamo G" first="Giovanni" last="De Girolamo">Giovanni De Girolamo</name></author><author><name sortKey="Gureje, Oye" sort="Gureje, Oye" uniqKey="Gureje O" first="Oye" last="Gureje">Oye Gureje</name></author><author><name sortKey="Haro, Josep Maria" sort="Haro, Josep Maria" uniqKey="Haro J" first="Josep Maria" last="Haro">Josep Maria Haro</name></author><author><name sortKey="He, Yanling" sort="He, Yanling" uniqKey="He Y" first="Yanling" last="He">Yanling He</name></author><author><name sortKey="Hinkov, Hristo" sort="Hinkov, Hristo" uniqKey="Hinkov H" first="Hristo" last="Hinkov">Hristo Hinkov</name></author><author><name sortKey="Hu, Chiyi" sort="Hu, Chiyi" uniqKey="Hu C" first="Chiyi" last="Hu">Chiyi Hu</name></author><author><name sortKey="De Jonge, Peter" sort="De Jonge, Peter" uniqKey="De Jonge P" first="Peter" last="De Jonge">Peter De Jonge</name></author><author><name sortKey="Karam, Elie G" sort="Karam, Elie G" uniqKey="Karam E" first="Elie G." last="Karam">Elie G. Karam</name></author><author><name sortKey="Lee, Sing" sort="Lee, Sing" uniqKey="Lee S" first="Sing" last="Lee">Sing Lee</name></author><author><name sortKey="Lepine, Jean Pierre" sort="Lepine, Jean Pierre" uniqKey="Lepine J" first="Jean-Pierre" last="Lepine">Jean-Pierre Lepine</name></author><author><name sortKey="Levinson, Daphna" sort="Levinson, Daphna" uniqKey="Levinson D" first="Daphna" last="Levinson">Daphna Levinson</name></author><author><name sortKey="Mneimneh, Zeina" sort="Mneimneh, Zeina" uniqKey="Mneimneh Z" first="Zeina" last="Mneimneh">Zeina Mneimneh</name></author><author><name sortKey="Navarro Mateu, Fernando" sort="Navarro Mateu, Fernando" uniqKey="Navarro Mateu F" first="Fernando" last="Navarro-Mateu">Fernando Navarro-Mateu</name></author><author><name sortKey="Posada Villa, Jose" sort="Posada Villa, Jose" uniqKey="Posada Villa J" first="José" last="Posada-Villa">José Posada-Villa</name></author><author><name sortKey="Slade, Tim" sort="Slade, Tim" uniqKey="Slade T" first="Tim" last="Slade">Tim Slade</name></author><author><name sortKey="Stein, Dan J" sort="Stein, Dan J" uniqKey="Stein D" first="Dan J." last="Stein">Dan J. Stein</name></author><author><name sortKey="Torres, Yolanda" sort="Torres, Yolanda" uniqKey="Torres Y" first="Yolanda" last="Torres">Yolanda Torres</name></author><author><name sortKey="Uda, Hidenori" sort="Uda, Hidenori" uniqKey="Uda H" first="Hidenori" last="Uda">Hidenori Uda</name></author><author><name sortKey="Wojtyniak, Bogdan" sort="Wojtyniak, Bogdan" uniqKey="Wojtyniak B" first="Bogdan" last="Wojtyniak">Bogdan Wojtyniak</name></author><author><name sortKey="Kessler, Ronald C" sort="Kessler, Ronald C" uniqKey="Kessler R" first="Ronald C." last="Kessler">Ronald C. Kessler</name></author><author><name sortKey="Chatterji, Somnath" sort="Chatterji, Somnath" uniqKey="Chatterji S" first="Somnath" last="Chatterji">Somnath Chatterji</name></author><author><name sortKey="Scott, Kate M" sort="Scott, Kate M" uniqKey="Scott K" first="Kate M." last="Scott">Kate M. Scott</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28297020</idno><idno type="pmc">5594751</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594751</idno><idno type="RBID">PMC:5594751</idno><idno type="doi">10.1001/jamapsychiatry.2017.0056</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">001E84</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001E84</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cross-sectional Comparison of the Epidemiology of <italic>DSM-5</italic> Generalized Anxiety Disorder Across the Globe</title><author><name sortKey="Ruscio, Ayelet Meron" sort="Ruscio, Ayelet Meron" uniqKey="Ruscio A" first="Ayelet Meron" last="Ruscio">Ayelet Meron Ruscio</name></author><author><name sortKey="Hallion, Lauren S" sort="Hallion, Lauren S" uniqKey="Hallion L" first="Lauren S." last="Hallion">Lauren S. Hallion</name></author><author><name sortKey="Lim, Carmen C W" sort="Lim, Carmen C W" uniqKey="Lim C" first="Carmen C. W." last="Lim">Carmen C. W. Lim</name></author><author><name sortKey="Aguilar Gaxiola, Sergio" sort="Aguilar Gaxiola, Sergio" uniqKey="Aguilar Gaxiola S" first="Sergio" last="Aguilar-Gaxiola">Sergio Aguilar-Gaxiola</name></author><author><name sortKey="Al Hamzawi, Ali" sort="Al Hamzawi, Ali" uniqKey="Al Hamzawi A" first="Ali" last="Al-Hamzawi">Ali Al-Hamzawi</name></author><author><name sortKey="Alonso, Jordi" sort="Alonso, Jordi" uniqKey="Alonso J" first="Jordi" last="Alonso">Jordi Alonso</name></author><author><name sortKey="Andrade, Laura Helena" sort="Andrade, Laura Helena" uniqKey="Andrade L" first="Laura Helena" last="Andrade">Laura Helena Andrade</name></author><author><name sortKey="Borges, Guilherme" sort="Borges, Guilherme" uniqKey="Borges G" first="Guilherme" last="Borges">Guilherme Borges</name></author><author><name sortKey="Bromet, Evelyn J" sort="Bromet, Evelyn J" uniqKey="Bromet E" first="Evelyn J." last="Bromet">Evelyn J. Bromet</name></author><author><name sortKey="Bunting, Brendan" sort="Bunting, Brendan" uniqKey="Bunting B" first="Brendan" last="Bunting">Brendan Bunting</name></author><author><name sortKey="De Almeida, Jose Miguel Caldas" sort="De Almeida, Jose Miguel Caldas" uniqKey="De Almeida J" first="José Miguel Caldas" last="De Almeida">José Miguel Caldas De Almeida</name></author><author><name sortKey="Demyttenaere, Koen" sort="Demyttenaere, Koen" uniqKey="Demyttenaere K" first="Koen" last="Demyttenaere">Koen Demyttenaere</name></author><author><name sortKey="Florescu, Silvia" sort="Florescu, Silvia" uniqKey="Florescu S" first="Silvia" last="Florescu">Silvia Florescu</name></author><author><name sortKey="De Girolamo, Giovanni" sort="De Girolamo, Giovanni" uniqKey="De Girolamo G" first="Giovanni" last="De Girolamo">Giovanni De Girolamo</name></author><author><name sortKey="Gureje, Oye" sort="Gureje, Oye" uniqKey="Gureje O" first="Oye" last="Gureje">Oye Gureje</name></author><author><name sortKey="Haro, Josep Maria" sort="Haro, Josep Maria" uniqKey="Haro J" first="Josep Maria" last="Haro">Josep Maria Haro</name></author><author><name sortKey="He, Yanling" sort="He, Yanling" uniqKey="He Y" first="Yanling" last="He">Yanling He</name></author><author><name sortKey="Hinkov, Hristo" sort="Hinkov, Hristo" uniqKey="Hinkov H" first="Hristo" last="Hinkov">Hristo Hinkov</name></author><author><name sortKey="Hu, Chiyi" sort="Hu, Chiyi" uniqKey="Hu C" first="Chiyi" last="Hu">Chiyi Hu</name></author><author><name sortKey="De Jonge, Peter" sort="De Jonge, Peter" uniqKey="De Jonge P" first="Peter" last="De Jonge">Peter De Jonge</name></author><author><name sortKey="Karam, Elie G" sort="Karam, Elie G" uniqKey="Karam E" first="Elie G." last="Karam">Elie G. Karam</name></author><author><name sortKey="Lee, Sing" sort="Lee, Sing" uniqKey="Lee S" first="Sing" last="Lee">Sing Lee</name></author><author><name sortKey="Lepine, Jean Pierre" sort="Lepine, Jean Pierre" uniqKey="Lepine J" first="Jean-Pierre" last="Lepine">Jean-Pierre Lepine</name></author><author><name sortKey="Levinson, Daphna" sort="Levinson, Daphna" uniqKey="Levinson D" first="Daphna" last="Levinson">Daphna Levinson</name></author><author><name sortKey="Mneimneh, Zeina" sort="Mneimneh, Zeina" uniqKey="Mneimneh Z" first="Zeina" last="Mneimneh">Zeina Mneimneh</name></author><author><name sortKey="Navarro Mateu, Fernando" sort="Navarro Mateu, Fernando" uniqKey="Navarro Mateu F" first="Fernando" last="Navarro-Mateu">Fernando Navarro-Mateu</name></author><author><name sortKey="Posada Villa, Jose" sort="Posada Villa, Jose" uniqKey="Posada Villa J" first="José" last="Posada-Villa">José Posada-Villa</name></author><author><name sortKey="Slade, Tim" sort="Slade, Tim" uniqKey="Slade T" first="Tim" last="Slade">Tim Slade</name></author><author><name sortKey="Stein, Dan J" sort="Stein, Dan J" uniqKey="Stein D" first="Dan J." last="Stein">Dan J. Stein</name></author><author><name sortKey="Torres, Yolanda" sort="Torres, Yolanda" uniqKey="Torres Y" first="Yolanda" last="Torres">Yolanda Torres</name></author><author><name sortKey="Uda, Hidenori" sort="Uda, Hidenori" uniqKey="Uda H" first="Hidenori" last="Uda">Hidenori Uda</name></author><author><name sortKey="Wojtyniak, Bogdan" sort="Wojtyniak, Bogdan" uniqKey="Wojtyniak B" first="Bogdan" last="Wojtyniak">Bogdan Wojtyniak</name></author><author><name sortKey="Kessler, Ronald C" sort="Kessler, Ronald C" uniqKey="Kessler R" first="Ronald C." last="Kessler">Ronald C. Kessler</name></author><author><name sortKey="Chatterji, Somnath" sort="Chatterji, Somnath" uniqKey="Chatterji S" first="Somnath" last="Chatterji">Somnath Chatterji</name></author><author><name sortKey="Scott, Kate M" sort="Scott, Kate M" uniqKey="Scott K" first="Kate M." last="Scott">Kate M. Scott</name></author></analytic><series><title level="j">JAMA psychiatry</title><idno type="ISSN">2168-622X</idno><idno type="eISSN">2168-6238</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>IMPORTANCE</title><p id="P1">Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, and debates persist about the seriousness of this disorder. Few data exist on GAD outside a small number of affluent, industrialized nations. No population-based data exist on GAD as it is currently defined in <italic>DSM-5</italic>.</p></sec><sec id="S2"><title>OBJECTIVE</title><p id="P2">To provide the first epidemiologic data on <italic>DSM-5</italic> GAD and explore cross-national differences in its prevalence, course, correlates, and impact.</p></sec><sec id="S3"><title>DESIGN, SETTING, AND PARTICIPANTS</title><p id="P3">Data come from the World Health Organization World Mental Health Survey Initiative. Cross-sectional general population surveys were carried out in 26 countries using a consistent research protocol and assessment instrument. A total of 147 261 adults from representative household samples were interviewed face-to-face in the community. The surveys were conducted between 2001 and 2012. Data analysis was performed from July 22, 2015, to December 12, 2016.</p></sec><sec id="S4"><title>MAIN OUTCOMES AND MEASURES</title><p id="P4">The Composite International Diagnostic Interview was used to assess GAD along with comorbid disorders, role impairment, and help seeking.</p></sec><sec id="S5"><title>RESULTS</title><p id="P5">Respondents were 147 261 adults aged 18 to 99 years. The surveys had a weighted mean response rate of 69.5%. Across surveys, <italic>DSM-5</italic> GAD had a combined lifetime prevalence (SE) of 3.7%(0.1%), 12-month prevalence of 1.8%(0.1%), and 30-day prevalence of 0.8%(0). Prevalence estimates varied widely across countries, with lifetime prevalence highest in high-income countries (5.0% [0.1%]), lower in middle-income countries (2.8% [0.1%]), and lowest in low-income countries (1.6% [0.1%]). Generalized anxiety disorder typically begins in adulthood and persists over time, although onset is later and clinical course is more persistent in lower-income countries. Lifetime comorbidity is high (81.9% [0.7%]), particularly with mood (63.0% [0.9%]) and other anxiety (51.7% [0.9%]) disorders. Severe role impairment is common across life domains (50.6% [1.2%]), particularly in high-income countries. Treatment is sought by approximately half of affected individuals (49.2% [1.2%]), especially those with severe role impairment (59.4% [1.8%]) or comorbid disorders (55.8% [1.4%]) and those living in high-income countries (59.0% [1.3%]).</p></sec><sec id="S6"><title>CONCLUSIONS AND RELEVANCE</title><p id="P6">The findings of this study show that <italic>DSM-5</italic> GAD is more prevalent than <italic>DSM-IV</italic> GAD and is associated with substantial role impairment. The disorder is especially common and impairing in high-income countries despite a negative association between GAD and socioeconomic status within countries. These results underscore the public health significance of GAD across the globe while uncovering cross-national differences in prevalence, course, and impairment that require further investigation.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101589550</journal-id><journal-id journal-id-type="pubmed-jr-id">40869</journal-id><journal-id journal-id-type="nlm-ta">JAMA Psychiatry</journal-id><journal-id journal-id-type="iso-abbrev">JAMA Psychiatry</journal-id><journal-title-group><journal-title>JAMA psychiatry</journal-title></journal-title-group><issn pub-type="ppub">2168-622X</issn><issn pub-type="epub">2168-6238</issn></journal-meta><article-meta><article-id pub-id-type="pmid">28297020</article-id><article-id pub-id-type="pmc">5594751</article-id><article-id pub-id-type="doi">10.1001/jamapsychiatry.2017.0056</article-id><article-id pub-id-type="manuscript">NIHMS902158</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Cross-sectional Comparison of the Epidemiology of <italic>DSM-5</italic> Generalized Anxiety Disorder Across the Globe</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Ruscio</surname><given-names>Ayelet Meron</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Hallion</surname><given-names>Lauren S.</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Lim</surname><given-names>Carmen C.W.</given-names></name><degrees>MSc</degrees></contrib><contrib contrib-type="author"><name><surname>Aguilar-Gaxiola</surname><given-names>Sergio</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Al-Hamzawi</surname><given-names>Ali</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Alonso</surname><given-names>Jordi</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Andrade</surname><given-names>Laura Helena</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Borges</surname><given-names>Guilherme</given-names></name><degrees>ScD</degrees></contrib><contrib contrib-type="author"><name><surname>Bromet</surname><given-names>Evelyn J.</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Bunting</surname><given-names>Brendan</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>de Almeida</surname><given-names>José Miguel Caldas</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Demyttenaere</surname><given-names>Koen</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Florescu</surname><given-names>Silvia</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>de Girolamo</surname><given-names>Giovanni</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Gureje</surname><given-names>Oye</given-names></name><degrees>MD, PhD, FRCPsych</degrees></contrib><contrib contrib-type="author"><name><surname>Haro</surname><given-names>Josep Maria</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>He</surname><given-names>Yanling</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Hinkov</surname><given-names>Hristo</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Hu</surname><given-names>Chiyi</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>de Jonge</surname><given-names>Peter</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Karam</surname><given-names>Elie G.</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Sing</given-names></name><degrees>MB, BS</degrees></contrib><contrib contrib-type="author"><name><surname>Lepine</surname><given-names>Jean-Pierre</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Levinson</surname><given-names>Daphna</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Mneimneh</surname><given-names>Zeina</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Navarro-Mateu</surname><given-names>Fernando</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Posada-Villa</surname><given-names>José</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Slade</surname><given-names>Tim</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Stein</surname><given-names>Dan J.</given-names></name><degrees>FRCP, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Torres</surname><given-names>Yolanda</given-names></name><degrees>MPH</degrees></contrib><contrib contrib-type="author"><name><surname>Uda</surname><given-names>Hidenori</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Wojtyniak</surname><given-names>Bogdan</given-names></name><degrees>ScD</degrees></contrib><contrib contrib-type="author"><name><surname>Kessler</surname><given-names>Ronald C.</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Chatterji</surname><given-names>Somnath</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Scott</surname><given-names>Kate M.</given-names></name><degrees>PhD</degrees></contrib><aff id="A1">Department of Psychology, University of Pennsylvania, Philadelphia (Ruscio); Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania (Hallion); Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand (Lim, Scott); Center for Reducing Health Disparities, University of California Davis Health System, Sacramento (Aguilar-Gaxiola); College of Medicine, Al-Qadisiya University, Diwania Governorate, Iraq (Al-Hamzawi); Health Services Research Unit, Institut Municipal d’Investigació Médica–Hospital del Mar Medical Research Institute, Barcelona, Spain (Alonso); Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain (Alonso); CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain (Alonso); Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil (Andrade); Calzada México Xochimilco No. 101 Delegación Tlalpan, Distrito Federal, Mexico (Borges); Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York (Bromet); School of Psychology, Ulster University, Londonderry, United Kingdom (Bunting); Chronic Diseases Research Center and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal (Caldas de Almeida); Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium (Demyttenaere); National School of Public Health, Management and Professional Development, Bucharest, Romania (Florescu); Istituto Di Ricovero e Cura a Carattere Scientifico, St John of God Clinical Research Centre, Brescia, Italy (de Girolamo); Department of Psychiatry, University College Hospital, Ibadan, Nigeria (Gureje); Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red Salud Mental, Universitat de Barcelona, Barcelona, Spain (Haro); Shanghai Mental Health Center, Shanghai, China (He); National Center for Public Health and Analyses, Sofia, Bulgaria (Hinkov); Shenzhen Institute of Mental Health & Shenzhen Kanging Hospital, Shenzhen, China (Hu); Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, the Netherlands (de Jonge); Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands (de Jonge); Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon (Karam); Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon (Karam); Institute for Development Research Advocacy and Applied Care, Beirut, Lebanon (Karam, Mneimneh); Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong (Lee); Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes, Paris, France (Lepine); Ministry of Health Israel, Mental Health Services, Jerusalem, Israel (Levinson); Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor (Mneimneh); Unidad de Docencia, Investigación y Formación en Salud Mental, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, Instituto Murciano de Investigación Biosanitaria–Arrixaca, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública–Murcia, Murcia, Spain (Navarro-Mateu); Colegio Mayor de Cundinamarca University, Bogota, Colombia (Posada-Villa); National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia (Slade); Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Republic of South Africa (Stein); Center for Excellence on Research in Mental Health, CES University, Medellín, Colombia (Torres); Health, Social Welfare, and Environmental Department, Kagoshima Regional Promotion Bureau, Kagoshima Prefecture, Japan (Uda); Centre of Monitoring and Analyses of Population Health, National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland (Wojtyniak); Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (Kessler); Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland (Chatterji)</aff></contrib-group><author-notes><corresp id="FN1">Corresponding Author: Ayelet Meron Ruscio, PhD, Department of Psychology, University of Pennsylvania, The Stephen A. Levin Building, 425 S University Ave, Philadelphia, PA 19104 (<email>ruscio@psych.upenn.edu</email>)</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>29</day><month>8</month><year>2017</year></pub-date><pub-date pub-type="ppub"><day>01</day><month>5</month><year>2017</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>11</month><year>2017</year></pub-date><volume>74</volume><issue>5</issue><fpage>465</fpage><lpage>475</lpage><pmc-comment>elocation-id from pubmed: 10.1001/jamapsychiatry.2017.0056</pmc-comment>
<abstract><sec id="S1"><title>IMPORTANCE</title><p id="P1">Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, and debates persist about the seriousness of this disorder. Few data exist on GAD outside a small number of affluent, industrialized nations. No population-based data exist on GAD as it is currently defined in <italic>DSM-5</italic>.</p></sec><sec id="S2"><title>OBJECTIVE</title><p id="P2">To provide the first epidemiologic data on <italic>DSM-5</italic> GAD and explore cross-national differences in its prevalence, course, correlates, and impact.</p></sec><sec id="S3"><title>DESIGN, SETTING, AND PARTICIPANTS</title><p id="P3">Data come from the World Health Organization World Mental Health Survey Initiative. Cross-sectional general population surveys were carried out in 26 countries using a consistent research protocol and assessment instrument. A total of 147 261 adults from representative household samples were interviewed face-to-face in the community. The surveys were conducted between 2001 and 2012. Data analysis was performed from July 22, 2015, to December 12, 2016.</p></sec><sec id="S4"><title>MAIN OUTCOMES AND MEASURES</title><p id="P4">The Composite International Diagnostic Interview was used to assess GAD along with comorbid disorders, role impairment, and help seeking.</p></sec><sec id="S5"><title>RESULTS</title><p id="P5">Respondents were 147 261 adults aged 18 to 99 years. The surveys had a weighted mean response rate of 69.5%. Across surveys, <italic>DSM-5</italic> GAD had a combined lifetime prevalence (SE) of 3.7%(0.1%), 12-month prevalence of 1.8%(0.1%), and 30-day prevalence of 0.8%(0). Prevalence estimates varied widely across countries, with lifetime prevalence highest in high-income countries (5.0% [0.1%]), lower in middle-income countries (2.8% [0.1%]), and lowest in low-income countries (1.6% [0.1%]). Generalized anxiety disorder typically begins in adulthood and persists over time, although onset is later and clinical course is more persistent in lower-income countries. Lifetime comorbidity is high (81.9% [0.7%]), particularly with mood (63.0% [0.9%]) and other anxiety (51.7% [0.9%]) disorders. Severe role impairment is common across life domains (50.6% [1.2%]), particularly in high-income countries. Treatment is sought by approximately half of affected individuals (49.2% [1.2%]), especially those with severe role impairment (59.4% [1.8%]) or comorbid disorders (55.8% [1.4%]) and those living in high-income countries (59.0% [1.3%]).</p></sec><sec id="S6"><title>CONCLUSIONS AND RELEVANCE</title><p id="P6">The findings of this study show that <italic>DSM-5</italic> GAD is more prevalent than <italic>DSM-IV</italic> GAD and is associated with substantial role impairment. The disorder is especially common and impairing in high-income countries despite a negative association between GAD and socioeconomic status within countries. These results underscore the public health significance of GAD across the globe while uncovering cross-national differences in prevalence, course, and impairment that require further investigation.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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