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Functional impairment related to painful physical symptoms in patients with generalized anxiety disorder with or without comorbid major depressive disorder: post hoc analysis of a cross-sectional study.

Romera I, Montejo AL, Caballero F, Caballero L, ArbesĂș J, Polavieja P, Desaiah D, Gilaberte I - BMC Psychiatry (2011)

Bottom Line: It is known that painful physical symptoms (PPS) are associated with GAD, regardless the presence of comorbid major depressive disorder (MDD).Of those patients with GAD+MDD+ (n = 559), 436 (78.0%) had PPS, compared with GAD+MDD- (249 of 422, 59%) and controls (95 of 336, 28.3%).The presence of PPS was significantly associated with less productivity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Clinical Research Department, Lilly SA, Avenida de la Industria 30, Alcobendas, Spain. romera_irene@lilly.com

ABSTRACT

Background: Generalized anxiety disorder (GAD) is the most frequent anxiety disorder in primary care patients. It is known that painful physical symptoms (PPS) are associated with GAD, regardless the presence of comorbid major depressive disorder (MDD). However the specific role of such symptoms in patients' functional impairment is not well understood. The objective of the present study is to assess functional impairment related to the presence of PPS in patients with GAD.

Methods: This is a post hoc analysis of a cross-sectional study. Functioning, in the presence (overall pain score >30; Visual Analog Scale) or absence of PPS, was assessed using the Sheehan Disability Scale (SDS) in three groups of patients; 1) GAD and comorbid MDD (GAD+MDD+), 2) GAD without comorbid MDD (GAD+MDD-), 3) controls (GAD-MDD-). ANCOVA models were used.

Results: Of those patients with GAD+MDD+ (n = 559), 436 (78.0%) had PPS, compared with GAD+MDD- (249 of 422, 59%) and controls (95 of 336, 28.3%). Functioning worsened in both GAD groups in presence of PPS (SDS least squares mean total score: 16.1 vs. 9.8, p < 0.0001, GAD+MDD+; 14.3 vs. 8.2, p < 0.0001, GAD+MDD-). The presence of PPS was significantly associated with less productivity.

Conclusions: Functional impairment related to the presence of PPS was relevant. Clinical implications should be considered.

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Related in: MedlinePlus

Patient disposition. Abbreviations: HADS-A = Hospital Anxiety and Depression Scale-Anxiety subscale; GAD = Generalized anxiety disorder; MDD = Major depressive disorder; PPS = Painful physical symptoms.
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Figure 1: Patient disposition. Abbreviations: HADS-A = Hospital Anxiety and Depression Scale-Anxiety subscale; GAD = Generalized anxiety disorder; MDD = Major depressive disorder; PPS = Painful physical symptoms.

Mentions: This is a post hoc analysis of a cross-sectional, multicenter epidemiological study that evaluated the prevalence of PPS in GAD patients with or without MDD [8]. Briefly, the study was carried out in a primary care setting covering 87 sites in Spain during April-June, 2007. The study had 3 stages in its design, including a consecutive screening to identify high-risk patients for GAD, a diagnosis confirmation of GAD along with an evaluation of the presence or absence of comorbid MDD, and a clinical evaluation for the presence of PPS (Figure 1).


Functional impairment related to painful physical symptoms in patients with generalized anxiety disorder with or without comorbid major depressive disorder: post hoc analysis of a cross-sectional study.

Romera I, Montejo AL, Caballero F, Caballero L, ArbesĂș J, Polavieja P, Desaiah D, Gilaberte I - BMC Psychiatry (2011)

Patient disposition. Abbreviations: HADS-A = Hospital Anxiety and Depression Scale-Anxiety subscale; GAD = Generalized anxiety disorder; MDD = Major depressive disorder; PPS = Painful physical symptoms.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3108915&req=5

Figure 1: Patient disposition. Abbreviations: HADS-A = Hospital Anxiety and Depression Scale-Anxiety subscale; GAD = Generalized anxiety disorder; MDD = Major depressive disorder; PPS = Painful physical symptoms.
Mentions: This is a post hoc analysis of a cross-sectional, multicenter epidemiological study that evaluated the prevalence of PPS in GAD patients with or without MDD [8]. Briefly, the study was carried out in a primary care setting covering 87 sites in Spain during April-June, 2007. The study had 3 stages in its design, including a consecutive screening to identify high-risk patients for GAD, a diagnosis confirmation of GAD along with an evaluation of the presence or absence of comorbid MDD, and a clinical evaluation for the presence of PPS (Figure 1).

Bottom Line: It is known that painful physical symptoms (PPS) are associated with GAD, regardless the presence of comorbid major depressive disorder (MDD).Of those patients with GAD+MDD+ (n = 559), 436 (78.0%) had PPS, compared with GAD+MDD- (249 of 422, 59%) and controls (95 of 336, 28.3%).The presence of PPS was significantly associated with less productivity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Clinical Research Department, Lilly SA, Avenida de la Industria 30, Alcobendas, Spain. romera_irene@lilly.com

ABSTRACT

Background: Generalized anxiety disorder (GAD) is the most frequent anxiety disorder in primary care patients. It is known that painful physical symptoms (PPS) are associated with GAD, regardless the presence of comorbid major depressive disorder (MDD). However the specific role of such symptoms in patients' functional impairment is not well understood. The objective of the present study is to assess functional impairment related to the presence of PPS in patients with GAD.

Methods: This is a post hoc analysis of a cross-sectional study. Functioning, in the presence (overall pain score >30; Visual Analog Scale) or absence of PPS, was assessed using the Sheehan Disability Scale (SDS) in three groups of patients; 1) GAD and comorbid MDD (GAD+MDD+), 2) GAD without comorbid MDD (GAD+MDD-), 3) controls (GAD-MDD-). ANCOVA models were used.

Results: Of those patients with GAD+MDD+ (n = 559), 436 (78.0%) had PPS, compared with GAD+MDD- (249 of 422, 59%) and controls (95 of 336, 28.3%). Functioning worsened in both GAD groups in presence of PPS (SDS least squares mean total score: 16.1 vs. 9.8, p < 0.0001, GAD+MDD+; 14.3 vs. 8.2, p < 0.0001, GAD+MDD-). The presence of PPS was significantly associated with less productivity.

Conclusions: Functional impairment related to the presence of PPS was relevant. Clinical implications should be considered.

Show MeSH
Related in: MedlinePlus