Frequency of Generalized Anxiety Disorder in Chinese Primary Care

Objective: This study aimed to assess the frequency of generalized anxiety disorder (GAD) among primary care patients in China. We also determined the rate of comorbid major depression (MD) in patients with GAD and explored the differences in sociodemographic and health-related characteristics between patients with and without GAD. Method: We invited consecutive outpatients who presented to 4 primary care facilities in Shanghai, China to fill out a survey composed of a screening questionnaire based on the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV) for GAD (GAD-7), the Zung Self-Rating Depression Scale (SDS), and various sociodemographic and health-related variables. The 4 primary care facilities covered urban and suburban areas of the city. Patients completed the survey in the reception area as they waited for their medical appointment. Results: The frequency of GAD in Chinese primary care was 4.1% (3.9% for males and 4.3% for females). This estimate was based on 127 positive results among a total of 3073 surveys collected. Of the patients who screened positive for GAD, 72.4% also screened positive for MD. Patients with GAD were more likely to report chronic medical conditions and to attend a university-affiliated primary care clinic. Conclusion: Our results showed that the frequency of GAD was significantly high in Chinese primary care patients. Compared with the GAD prevalence in the Chinese general population from previously published studies, our findings suggest a link between GAD and health-seeking behaviors. Generalized anxiety disorder was also strongly correlated with MD. Integration of a routine GAD screening regime merits serious consideration to screen, diagnose, and treat patients with GAD in the primary care setting.