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spelling The case for eliminating excessive worry as a requirement for generalized anxiety disorderA cross-national investigationclassificationdiagnosisepidemiologygeneralized anxiety disorderglobal mental healthworryApplied PsychologyPsychiatry and Mental healthSDG 3 - Good Health and Well-beingPublisher Copyright: Copyright © The Author(s), 2024. Published by Cambridge University Press.Background Around the world, people living in objectively difficult circumstances who experience symptoms of generalized anxiety disorder (GAD) do not qualify for a diagnosis because their worry is not 'excessive' relative to the context. We carried out the first large-scale, cross-national study to explore the implications of removing this excessiveness requirement. Methods Data come from the World Health Organization World Mental Health Survey Initiative. A total of 133 614 adults from 12 surveys in Low- or Middle-Income Countries (LMICs) and 16 surveys in High-Income Countries (HICs) were assessed with the Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-5 criteria for GAD were compared to respondents meeting all criteria for GAD, and to respondents without GAD, on clinically-relevant correlates. Results Removing the excessiveness requirement increases the global lifetime prevalence of GAD from 2.6% to 4.0%, with larger increases in LMICs than HICs. Non-excessive and excessive GAD cases worry about many of the same things, although non-excessive cases worry more about health/welfare of loved ones, and less about personal or non-specific concerns, than excessive cases. Non-excessive cases closely resemble excessive cases in socio-demographic characteristics, family history of GAD, and risk of temporally secondary comorbidity and suicidality. Although non-excessive cases are less severe on average, they report impairment comparable to excessive cases and often seek treatment for GAD symptoms. Conclusions Individuals with non-excessive worry who meet all other DSM-5 criteria for GAD are clinically significant cases. Eliminating the excessiveness requirement would lead to a more defensible GAD diagnosis.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNRuscio, Ayelet MeronRassaby, MadeleineStein, Murray B.Stein, Dan J.Aguilar-Gaxiola, SergioAl-Hamzawi, AliAlonso, JordiAtwoli, LukoyeBorges, GuilhermeBromet, Evelyn J.Bruffaerts, RonnyBunting, BrendanCardoso, GraçaChardoul, StephanieDe Girolamo, GiovanniDe Jonge, PeterGureje, OyeHaro, Josep MariaKaram, Elie G.Karam, AimeeKiejna, AndrzejKovess-Masfety, VivianeLee, SueNavarro-Mateu, FernandoNishi, DaisukePiazza, MarinaPosada-Villa, JoséSampson, Nancy A.Scott, Kate M.Slade, TimStagnaro, Juan CarlosTorres, YolandaViana, Maria CarmenVladescu, CristianZarkov, ZahariKessler, Ronald C.2024-11-28T23:10:04Z2024-102024-10-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/175991eng0033-2917PURE: 103623171https://doi.org/10.1017/S003329172400182Xinfo:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-05-12T01:45:04Zoai:run.unl.pt:10362/175991Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T19:16:52.347247Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv The case for eliminating excessive worry as a requirement for generalized anxiety disorder
A cross-national investigation
title The case for eliminating excessive worry as a requirement for generalized anxiety disorder
spellingShingle The case for eliminating excessive worry as a requirement for generalized anxiety disorder
Ruscio, Ayelet Meron
classification
diagnosis
epidemiology
generalized anxiety disorder
global mental health
worry
Applied Psychology
Psychiatry and Mental health
SDG 3 - Good Health and Well-being
title_short The case for eliminating excessive worry as a requirement for generalized anxiety disorder
title_full The case for eliminating excessive worry as a requirement for generalized anxiety disorder
title_fullStr The case for eliminating excessive worry as a requirement for generalized anxiety disorder
title_full_unstemmed The case for eliminating excessive worry as a requirement for generalized anxiety disorder
title_sort The case for eliminating excessive worry as a requirement for generalized anxiety disorder
author Ruscio, Ayelet Meron
author_facet Ruscio, Ayelet Meron
Rassaby, Madeleine
Stein, Murray B.
Stein, Dan J.
Aguilar-Gaxiola, Sergio
Al-Hamzawi, Ali
Alonso, Jordi
Atwoli, Lukoye
Borges, Guilherme
Bromet, Evelyn J.
Bruffaerts, Ronny
Bunting, Brendan
Cardoso, Graça
Chardoul, Stephanie
De Girolamo, Giovanni
De Jonge, Peter
Gureje, Oye
Haro, Josep Maria
Karam, Elie G.
Karam, Aimee
Kiejna, Andrzej
Kovess-Masfety, Viviane
Lee, Sue
Navarro-Mateu, Fernando
Nishi, Daisuke
Piazza, Marina
Posada-Villa, José
Sampson, Nancy A.
Scott, Kate M.
Slade, Tim
Stagnaro, Juan Carlos
Torres, Yolanda
Viana, Maria Carmen
Vladescu, Cristian
Zarkov, Zahari
Kessler, Ronald C.
author_role author
author2 Rassaby, Madeleine
Stein, Murray B.
Stein, Dan J.
Aguilar-Gaxiola, Sergio
Al-Hamzawi, Ali
Alonso, Jordi
Atwoli, Lukoye
Borges, Guilherme
Bromet, Evelyn J.
Bruffaerts, Ronny
Bunting, Brendan
Cardoso, Graça
Chardoul, Stephanie
De Girolamo, Giovanni
De Jonge, Peter
Gureje, Oye
Haro, Josep Maria
Karam, Elie G.
Karam, Aimee
Kiejna, Andrzej
Kovess-Masfety, Viviane
Lee, Sue
Navarro-Mateu, Fernando
Nishi, Daisuke
Piazza, Marina
Posada-Villa, José
Sampson, Nancy A.
Scott, Kate M.
Slade, Tim
Stagnaro, Juan Carlos
Torres, Yolanda
Viana, Maria Carmen
Vladescu, Cristian
Zarkov, Zahari
Kessler, Ronald C.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Ruscio, Ayelet Meron
Rassaby, Madeleine
Stein, Murray B.
Stein, Dan J.
Aguilar-Gaxiola, Sergio
Al-Hamzawi, Ali
Alonso, Jordi
Atwoli, Lukoye
Borges, Guilherme
Bromet, Evelyn J.
Bruffaerts, Ronny
Bunting, Brendan
Cardoso, Graça
Chardoul, Stephanie
De Girolamo, Giovanni
De Jonge, Peter
Gureje, Oye
Haro, Josep Maria
Karam, Elie G.
Karam, Aimee
Kiejna, Andrzej
Kovess-Masfety, Viviane
Lee, Sue
Navarro-Mateu, Fernando
Nishi, Daisuke
Piazza, Marina
Posada-Villa, José
Sampson, Nancy A.
Scott, Kate M.
Slade, Tim
Stagnaro, Juan Carlos
Torres, Yolanda
Viana, Maria Carmen
Vladescu, Cristian
Zarkov, Zahari
Kessler, Ronald C.
dc.subject.por.fl_str_mv classification
diagnosis
epidemiology
generalized anxiety disorder
global mental health
worry
Applied Psychology
Psychiatry and Mental health
SDG 3 - Good Health and Well-being
topic classification
diagnosis
epidemiology
generalized anxiety disorder
global mental health
worry
Applied Psychology
Psychiatry and Mental health
SDG 3 - Good Health and Well-being
description Publisher Copyright: Copyright © The Author(s), 2024. Published by Cambridge University Press.
publishDate 2024
dc.date.none.fl_str_mv 2024-11-28T23:10:04Z
2024-10
2024-10-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/175991
url http://hdl.handle.net/10362/175991
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 0033-2917
PURE: 103623171
https://doi.org/10.1017/S003329172400182X
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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