Work Productivity and Activity Impairment Associated with Generalized Anxiety Disorder Among Adults in the United States

OBJECTIVES: Generalized anxiety disorder (GAD), characterized by excessive and pervasive worry, interferes with daily activities; yet, the impact of GAD on work and non-work performance is not well-understood. This study quantified the impact on work productivity and daily activities attributed to GAD, overall, and by symptom severity.

METHODS: This cross-sectional study analyzed data from the 2022 US National Health and Wellness Survey, a nationally representative, online-based survey. Adults (aged ≥18 years) diagnosed with GAD were categorized by symptom severity using the GAD-7 screening tool: no-symptoms (n=872, 0-4), mild (n=1,381, 5-9), moderate (n=1,100, 10-14), and severe (n=1,080, ≥15). Controls were defined as adults who reported no GAD diagnosis and had a negative GAD screen (n=36,505, GAD-7<10). The Work Productivity and Activity Impairment [WPAI] questionnaire was used to measure outcomes, including percentages of work time missed (absenteeism), impairment while at work (presenteeism), overall work productivity loss (a combination of absenteeism and presenteeism), and activity impairment because of one’s health. Confounder-adjusted outcomes were compared across GAD groups by symptom severity and versus controls using generalized linear models (negative binomial distribution, log link).

RESULTS: Compared with controls (8.0%, 95% confidence interval [CI]: 7.6%-8.4%), participants with severe GAD had significantly higher absenteeism (11.4%, 95%CI: 8.4%-15.5%). The severe GAD group reported the highest presenteeism (26.3%, 95%CI: 22.5%-30.7%), overall, followed by the moderate (24.1%, 95%CI: 20.8%-27.8%) and mild (22.6%, 95%CI: 20.1%-25.6%) groups, and controls had significantly lower presenteeism than the other groups (19.3%, 95%CI: 18.8%-19.7%). Similar trends by GAD symptom severity were observed for overall work productivity loss and activity impairment.

CONCLUSIONS: Greater GAD symptom severity is associated with greater work productivity loss and daily activity impairment. Our findings thus support efforts to effectively treat GAD symptoms to potentially mitigate negative impact on work and non-work activities among the GAD population.