The 4 main comorbidities of generalized anxiety disorder

A review of the most frequent comorbidities of generalized anxiety disorder.

Most anxiety disorders, such as social anxiety disorder or social phobia, panic disorder, agoraphobia or any type of specific phobia, are linked to a symptomatology related to a bodily sensation, an external situation or a specific stimulus. However, this does not occur in the case of generalized anxiety disorder.

In the case of generalized anxiety disorder (GAD), the symptoms are not triggered by any specific situation or stimulus, but occur without the person suffering from this disorder being able to detect which situations trigger the symptoms, there being a wide range of content among the threat signals.

However, it should be noted that comorbidities are common in generalized anxiety disorder, i.e., overlap between it and other disorders.i.e., overlap between this and other disorders. In this article we will see which are the most important ones putting the focus in the scope of the mental health.

• Article related: "Generalized Anxiety Disorder: symptoms, causes and treatment".

Characteristics of generalized anxiety disorder

The generalized anxiety disorder, according to the diagnostic manual of mental disorders DSM-5, is composed of symptoms of excessive worry and anxiety for at least 6 months and are associated with various activities and/or events.. Likewise, the person has serious difficulties in controlling their worries and anxiety symptoms, associated with 3 or more of the following symptoms: restlessness, fatigue, concentration difficulties, Muscle tension, irritability and sleep disturbances.

It should also be noted that the worry, anxiety or physiological symptoms cause significant discomfort or difficulties in their day-to-day life (e.g., academics, work, etc.). In addition, this disturbance cannot be attributed to the side effects of a substance or other health condition, nor can it be better explained by another mental disorder.

Below we will explain the most common comorbidities of generalized anxiety disorder.

The most important generalized anxiety disorder comorbidities.

There are clinical studies conducted with anxiety disorders that estimated that approximately 80% of patients suffering from any anxiety disorder often have comorbidities with another mental disorder.In most cases the second psychological disturbance is another anxiety disorder, although they also overlap with depressive or personality disorders.

In this sense, here we will see the most common comorbidities of generalized anxiety disorder,

1. Comorbidity of GAD with other anxiety disorders

Comorbidities of GAD often occur with other anxiety disorders (e.g., specific phobia, social phobia, agoraphobia, panic disorder, etc.).

The high degree of neuroticism or emotional liability usually found in patients with a generalized anxiety disorder are often the main factors that support comorbidity with other anxiety disorders being associated with the temperamental background of these patients.

There are also studies that have found that generalized anxiety disorder and other anxiety disorders have a number of environmental and genetic risk factors in common.

2. Comorbidity of GAD with depressive disorders

The second most common comorbidities of generalized anxiety disorder are those that occur with other depressive disorders, as can be major depressive disorder or dysthymia.It should be noted that there may also be comorbidity between generalized anxiety disorder and bipolar disorders.

3. Comorbidity of GAD with personality disorders

Other comorbidities of generalized anxiety disorder (GAD) are those that occur when patients with a diagnosis of GAD and also meet the criteria for a diagnosis of a personality disorder, especially obsessive-compulsive personality disorder, avoidant personality disorder and borderline personality disorder..

When there is a case in which there is any of the possible comorbidities of generalized anxiety disorder with a personality disorder, the patient usually suffers symptoms with a higher level of clinical severity than in the case of comorbidities with anxiety or depressive disorders, so the degree of negative interference in the various areas affected in the patient's life is also greater.

4. Comorbidity of GAD with other conditions

Cases have also been found with comorbidities of generalized anxiety disorder with other conditions such as headaches or irritable bowel syndrome (IBS), in which cases usually occur as a result of stress suffered by the patient on a prolonged basis.

Main comorbidities of generalized anxiety disorder in adolescents.

Generalized anxiety disorder has a low percentage of cases among the adolescent population; however, cases have also been found in these population groups, so it is worth highlighting what are the comorbidities of generalized anxiety disorder in this age group.

In Spain there is a study carried out with 962 participants aged between 12 and 16 years in which the following was found a prevalence of generalized anxiety disorder of 3% globally, with a prevalence of 2.4% in men and 3.7% in women.The prevalence of generalized anxiety disorder was 2.4% in men and 3.7% in women.

What was most striking was that comorbidities of generalized anxiety disorder were found in 58% of the cases with this disorder, the most common being that these comorbidities occurred together with another anxiety disorder in general, with 48.3%, which represents almost half of the cases with generalized anxiety disorder.

Other comorbidities of generalized anxiety disorder found in the study are also noteworthy. First, it was found that together with anxiety disorder there was a comorbidity of 20.7%; with oppositional defiant disorder, a comorbidity of 10.3% was found.The results showed a comorbidity of 13.8% with some anxiety disorders in isolation and not in general, such as agoraphobia, specific phobia, separation anxiety disorder and social phobia, for each disorder.

With eating disorders (ED), comorbidity of 13.8% was found for generalized anxiety disorder; with attention deficit hyperactivity disorder (ADHD), comorbidity of 13.8% was also observed, as was the case with oppositional defiant disorder; with obsessive-compulsive disorder and also with major depressive episode it was found that both presented a comorbidity with GAD of 6.9%; and finally, the least comorbidity with GAD was observed in the case of conduct disorder, with 3.4%.

Interference caused by generalized anxiety disorder comorbidities

When there are comorbidities of generalized anxiety disorder, as well as when it occurs in isolation, sufferers often suffer a number of negative consequences by interfering in a very significant way in their daily lives, as it affects various areas of everyday life (eg, work, academic, interpersonal relationships, health care ...).

The high levels of pathological worry often drain a great deal of time and energy from the person suffering from a generalized anxiety disorder.. Likewise, other symptoms of the disorder that are related such as muscle tension, nervousness, difficulty concentrating, difficulty sleeping or fatigue often contribute to the interference of the disorder in that diversity of areas of the patient's life, increasing all these problems and having another one more when comorbidities of generalized anxiety disorder occur in the same person.

On the other hand, the comorbidity between this and other disorders is associated with a high number of cases of sick leave and the suffering of high levels of distress, which in clinical psychology and medicine is known as a prolonged state of tension at the psychological level associated with suffering or anguish. the patient is unable to adapt to a series of factors that he or she perceives as threatening. and which may have been exacerbated by these comorbidities of generalized anxiety disorder.

Factors directly related to a worse prognosis of GAD

The factors that are directly related to a worse long-term prognosis of GAD are a worse long-term prognosis among people with generalized anxiety disorder (GAD) are as follows:

• The most severe, when there are comorbidities of generalized anxiety disorder with personality disorders.
• Comorbidities of generalized anxiety disorder with other anxiety and/or depressive disorders.
• When there are high levels of neuroticism.
• When the symptoms of GAD present high levels of severity.
• Having a low socioeconomic level.
• Having a poor social adjustment.
• Not having a job.