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GAD Associated with High Secondary Care Cost


Generalized anxiety disorder (GAD) is a common but underdiagnosed mental disorder. Its estimated prevalence in the general population is 2–3 %, but the prevalence rises to nearly 8 % in primary care patients, making it one of the most common mental disorders a primary care physician encounters. However, many physicians fail to recognize GAD, and only one third of GAD patients are diagnosed correctly.

GAD is defined as a lengthened period of worry, tension and feeling of apprehension about every-day events and problems. Earlier studies have shown that GAD patients have as many visits to the physician as do depression patients. In line with this, work impairment associated with GAD is estimated to be 1.2 times higher than in rheumatoid arthritis or depression – both conditions considered to be a significant strain for both the individual and the society. What raises the costs of GAD are the significant psychological and somatic comorbidities associated with the condition.

We recently took part in a study where the secondary care costs of GAD were compared with those of major depressive disorder. The data was collected from Finnish hospital discharge registers, and the costs of a 48-month follow-up period were subsequently analyzed. In this study by Kujanpää et al. the highest costs were observed among those patients who had both GAD and a history of depression or some other anxiety disorder. Most of the costs were due to psychiatric treatment costs. Overall, the cumulative costs of patients with GAD – regardless of medical history – were comparable with those of major depressive disorder.

This study indicates that the economic burden of individual GAD patients is comparable with that of major depressive disorder patients in secondary care. It also highlights the nature of GAD as a major public health problem, which requires more attention in both primary and secondary health care.


Kujanpää T, Ylisaukko-Oja T, Jokelainen J, Linna M, Timonen M. Comparative cost analysis of generalized anxiety disorder and major depressive disorder patients in secondary care from a national hospital registry in Finland. Nord J Psychiatry. 2013 Aug 12. [Epub ahead of print]



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