Health-Related Quality of Life Across the Anxiety Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

Jonathan S. Comer, PhD; Carlos Blanco, MD, PhD; Deborah S. Hasin, PhD; Shang-Min Liu, MS; Bridget F. Grant, PhD, PhD; J. Blake Turner, PhD; and Mark Olfson, MD, MPH

Published: August 24, 2010

Article Abstract

Objective: Although clinical studies have documented that specific anxiety disorders are associated with impaired psychosocial functioning, little is known regarding their comparative effects on health-related quality of life within a general population. The current analysis compares health-related quality of life in a US community-dwelling sample of adults with DSM-IV social anxiety disorder, generalized anxiety disorders (GAD), panic disorder, and specific phobia.

Method: A face-to-face survey of a US nationally representative sample of over 43,000 adults aged 18 years and older residing in households and group quarters was conducted. Prevalence of DSM-IV anxiety disorders and relative associations with health-related quality of life indicators were examined. The survey was conducted from 2001 to 2002.

Results: Roughly 9.8% of respondents met diagnostic criteria for at least 1 of 4 twelve-month DSM-IV anxiety disorders which, relative to the non-anxiety-disordered general population, were each associated with lower personal income, increased rates of 12-month physical conditions, and greater numbers of Axis I and Axis II DSM-IV psychiatric conditions. After adjusting for sociodemographic and clinical correlates, including other anxiety disorders, GAD was associated with significant decrements in the SF-12 mental component summary score. In similar models, GAD and, to a lesser extent, panic disorder were significantly associated with impairment in social functioning, role emotional, and mental health SF subscales.

Conclusions: GAD, followed by panic disorder, appears to exact significant and independent tolls on health-related quality of life. Results underscore the importance of prompt and accurate clinical identification and improving access to effective interventions for these disorders.

J Clin Psychiatry

Submitted: February 2, 2009; accepted August 3, 2009.

Online ahead of print: August 24, 2010 (doi:10.4088/JCP.09m05094blu).

Corresponding author: Mark Olfson, MD, MPH, Department of Psychiatry, Columbia University, College of Physicians and Surgeons, 1051 Riverside Drive, Unit 24, New York, NY, 10032 (

Volume: 71

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