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

doi:10.1186/1471-244X-11-69

BMC Psychiatry. 2011; 11: 69.

Published online 2011 April 21. doi: 10.1186/1471-244X-11-69

PMCID: PMC3108915

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

Irene Romera,¹ Ángel L Montejo,² Fernando Caballero,³ Luis Caballero,⁴ José Arbesú,⁵ Pepa Polavieja,¹ Durisala Desaiah,⁶ and Inmaculada Gilaberte¹

¹Clinical Research Department, Lilly, SA, Avenida de la Industria, 30, 28108 Alcobendas, Spain

²Hospital Universitario de Salamanca. School of Medicine, University of Salamanca, 37007 Salamanca, Spain

³Primary Care Research Department, 6th Health Area, Servicio Madrileño de Salud, 28020 Madrid, Spain

⁴Psychiatry Department, Hospital Puerta de Hierro, 28222 Madrid, Spain

⁵Primary Care Department, Centro de Salud de la Ería, 33013 Oviedo, Spain

⁶Consultant Scientific Communications and Training Lead, MCH - 92, Drop Code - 6122 Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA

Corresponding author.

Irene Romera: romera_irene/at/lilly.com; Ángel L Montejo: amontejo/at/usal.es; Fernando Caballero: fcaballero/at/papps.org; Luis Caballero: luiscabmar/at/yahoo.es; José Arbesú: jarbesuprieto/at/hotmail.com; Pepa Polavieja: polavieja_pepa/at/lilly.com; Durisala Desaiah: desaiah_durisala/at/lilly.com; Inmaculada Gilaberte: gilaberte_inmaculada/at/lilly.com

Received January 17, 2011; Accepted April 21, 2011.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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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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