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Threshold and subthreshold generalized anxiety disorder among US adolescents: prevalence, sociodemographic, and clinical characteristics

Published online by Cambridge University Press:  02 January 2014

M. Burstein ,
K. Beesdo-Baum ,
J.-P. He  and
K. R. Merikangas
M. Burstein
Affiliation:
Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, MD, USA
K. Beesdo-Baum
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
J.-P. He
Affiliation:
Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, MD, USA
K. R. Merikangas*
Affiliation:
Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, MD, USA
*
*Address for correspondence: K. R. Merikangas, Ph.D., National Institute of Mental Health, Genetic Epidemiology Research Branch, Building 35, Room 1A201, 35 Convent Drive, MSC #3720, Bethesda, MD 20892, USA. (Email: kathleen.merikangas@nih.gov)
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Abstract

Background

Threshold and subthreshold forms of generalized anxiety disorder (GAD) are highly prevalent and impairing conditions among adults. However, there are few general population studies that have examined these conditions during the early life course. The primary objectives of this study were to: (1) examine the prevalence, and sociodemographic and clinical characteristics of threshold and subthreshold forms of GAD in a nationally representative sample of US youth; and (2) test differences in sociodemographic and clinical characteristics between threshold and subthreshold forms of the disorder.

Method

The National Comorbidity Survey-Adolescent Supplement is a nationally representative face-to-face survey of 10 123 adolescents 13 to 18 years of age in the continental USA.

Results

Approximately 3% of adolescents met criteria for threshold GAD. Reducing the required duration from 6 months to 3 months resulted in a 65.7% increase in prevalence (5.0%); further relaxing the uncontrollability criterion led to an additional 20.7% increase in prevalence (6.1%). Adolescents with all forms of GAD displayed a recurrent clinical course marked by substantial impairment and co-morbidity with other psychiatric disorders. There were few significant differences in sociodemographic and clinical characteristics between threshold and subthreshold cases of GAD. Results also revealed age-related differences in the associated symptoms and clinical course of GAD.

Conclusions

Findings demonstrate the clinical significance of subthreshold forms of GAD among adolescent youth, highlighting the continuous nature of the GAD construct. Age-related differences in the associated symptoms and clinical course of GAD provide further support for criteria that capture variation in clinical features across development.

Keywords

Adolescentschildrenepidemiologygeneralized anxiety disordersubthreshold
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 11 , August 2014 , pp. 2351 - 2362
Copyright
Copyright © Cambridge University Press 2014 

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