Impairment and Functioning in a Sample of Primary Care Patients With Generalized Anxiety Disorder: Results From the Primary Care Anxiety Project

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Objective: To examine the extent of functional impairment associated with generalized anxiety disorder (GAD) in a sample of primary care patients.

Method: Participants (N = 128) were part of the Primary Care Anxiety Project (PCAP), a study conducted in 15 primary care practices in the northeastern United States. Patients were recruited in primary care practice waiting rooms from July 1997 to May 2001. Participants screening positive for anxiety symptoms received a diagnostic interview and an assessment of health-related functioning (Medical Outcomes Study 36-item Short-Form Health Survey [SF-36]). Effect sizes are reported for comparisons of SF-36 scores between patients with a DSM-IV diagnosis of GAD and general population and medical sample norms.

Results: Relative to general population normative SF-36 scores, primary care patients with GAD evidenced impaired functioning on both the physical and mental component summary scales. Patients with GAD also evidenced greater impairment in psychosocial functioning than that previously reported for samples of patients with major medical illnesses, including type II diabetes, hypertension, recent myocardial infarction, and congestive heart failure. This finding held true even when GAD patients with comorbid medical illnesses and comorbid Axis I mental disorders were excluded from the comparison.

Conclusions: Primary care patients with GAD experience substantial impairment that cannot be accounted for by concurrent medical illnesses or comorbid Axis I mental disorders.

Prim Care Companion J Clin Psychiatry 2010;12(5):e1–e8

Submitted: September 16, 2009; accepted December 2, 2009.

Published online: October 7, 2010 (doi:10.4088/PCC.09m00890blu).

Corresponding author: Risa B. Weisberg, PhD, Box G-BH, Duncan Bldg, Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912 (

Prim Care Companion J Clin Psychiatry 2010;12(5):e1-e8