Direct and Indirect Costs Associated With Generalized Anxiety Disorder Among Adults in the United States

OBJECTIVES: Generalized anxiety disorder (GAD), a prevalent mental health condition affecting millions of adults in the United States (US), may be associated with substantial economic burden. This study estimated the costs across adults diagnosed with GAD, those screened positive for GAD, and those without GAD in the US general population.

METHODS: This cross-sectional study analyzed data from the 2022 US National Health and Wellness Survey (N=75,261), an online self-report survey of adults (aged ≥18) that is representative of US Census on age, sex, and race/ethnicity. Using a validated 7-item scale for GAD screening (GAD-7), participants were categorized as follows: diagnosed GAD (reported GAD diagnosis, n=4,433); undiagnosed GAD (positive screen [GAD-7≥10] and no reported GAD diagnosis, n=13,759); and no-GAD (negative screen [GAD-7<10] and no reported GAD diagnosis, n=36,505).

Direct medical costs were calculated using 2021 Medical Expenditure Panel data for outpatient visits, hospitalizations, and emergency department visits. Indirect costs were estimated using the human capital approach. Groups were compared on confounder-adjusted annual costs using generalized linear models (negative binomial distribution, log link).

RESULTS: The adjusted total direct and indirect costs were $9,190 and $6,532, respectively, among no-GAD. Compared with no-GAD, the adjusted total direct costs were 1.27 and 1.96 times higher for diagnosed ($11,711) and undiagnosed GAD ($18,045), respectively (both, p<0.01); and the adjusted total indirect costs were 1.15 and 1.20 times higher for diagnosed ($7,507) and undiagnosed GAD ($7,805), respectively (both, p<0.01).

CONCLUSIONS: Individuals living with GAD whether already diagnosed or not, incurred a greater direct and indirect costs as compared to the general population. With the increasing prevalence of GAD, these findings highlight the need for more effective diagnosis and treatment of GAD to potentially mitigate economic burden on individuals and society.