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Am J Psychiatry 1993; 150:600-607
Copyright © 1993 by American Psychiatric Association
Quality of life and psychiatric morbidity in panic disorder and generalized anxiety disorder
AO Massion, MG Warshaw and MB Keller
Department of Psychiatry, University of Massachusetts Medical School, Worcester 01655.
OBJECTIVE: This report examines the impact of panic disorder and/or
generalized anxiety disorder on quality of life and the implications of
these findings on nosological categories. METHOD: A total of 357 subjects
with a current episode of panic disorder and/or generalized anxiety
disorder were diagnosed according to DSM-III-R criteria, using structured
clinical interviews, as part of a prospective, naturalistic, longitudinal,
multicenter study of a clinical population with anxiety disorders. RESULTS:
There was a high degree of coexistence of anxiety disorders and major
depressive disorder. Subjects with generalized anxiety disorder almost
universally had other disorders, were the most likely to have at least one
other anxiety disorder or major depressive disorder at intake, had the
earliest age at onset, and had the worst emotional health rating. Subjects
with panic disorder without agoraphobia had the most likelihood of a
history of alcohol abuse. Nine percent of the subjects had a history of
suicide attempts or gestures. CONCLUSIONS: The subjects showed significant
impairment in quality of life. The highly frequent coexistence of other
anxiety disorders with generalized anxiety disorder and the overall lack of
differences on many quality of life measures raise questions of nosology,
particularly for generalized anxiety disorder.
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