The Impact of Generalized Anxiety Disorder on Comorbid Conditions: A Systematic Review
Author(s)
Erin Ferries, MPH, PhD1, Susan Suponcic, BA, MA, MSc, PhD2, Derek Louie, PharmD, MS1, Aishwarya Kulkarni, MS3, Mason Yeh, PhD3, Abigail Silber, MPH3, Matthew O'Hara, MBA3, Phong Duong, PharmD1, Jeff Strawn, MD4, Roger McIntyre, MD, FRCPC5.
1MindMed, New York, NY, USA, 2Value & Access Advisors, LLC, St Petersburg, FL, USA, 3Trinity Life Sciences, Waltham, MA, USA, 4University of Cincinnati, Cincinnati, OH, USA, 5University of Toronto, Toronto, ON, Canada.
1MindMed, New York, NY, USA, 2Value & Access Advisors, LLC, St Petersburg, FL, USA, 3Trinity Life Sciences, Waltham, MA, USA, 4University of Cincinnati, Cincinnati, OH, USA, 5University of Toronto, Toronto, ON, Canada.
OBJECTIVES: Generalized anxiety disorder (GAD) is frequently comorbid with a range of psychiatric and physical comorbidities that contribute to comorbidity burden. This systematic literature review (SLR) aimed to highlight the patterns and outcomes associated with GAD as a comorbidity of other conditions.
METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, this SLR identified peer-reviewed manuscripts and conference abstracts published in English from January 2014 to December 2024 in PubMed, MEDLINE, and Embase. An Artificial Intelligence (AI)-enhanced platform was used to facilitate the review process. After the AI platform was trained on the first 50 title/abstract screenings, the remainder of the title/abstract screenings were conducted with one human and one AI screener that provided reviewer-level decisions, with adjudication by another independent human. Full texts were dual screened by independent human reviewers.
RESULTS: 27,040 publications were identified on Embase and PubMed. After de-duplication, 18,759 publications were reviewed. Title/abstract screening and full-text review yielded 135 publications that reported GAD as a comorbidity of other conditions. Common comorbidities included other psychiatric disorders (e.g., major depressive disorder, substance use disorder) as well as non-neuropsychiatric conditions (e.g., inflammatory bowel disease, chronic pain). Twenty publications reported that GAD occurring as a comorbidity that worsens patient outcomes. This includes higher risk of complications, lower remission rates, and increased healthcare resource utilization/costs (e.g., inpatient visits and medication expenses, etc.).
CONCLUSIONS: This review sheds light on the impact of GAD and its association and possible mechanistic overlap between GAD and comorbid psychiatric disorders. Based on this review, GAD is associated with worsened outcomes in various psychiatric and medical conditions, which can lead to increased HCRU directly associated with GAD and with comorbidities. This underscores the need for improved GAD interventions, in some cases with the context of comorbid disease burden.
METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, this SLR identified peer-reviewed manuscripts and conference abstracts published in English from January 2014 to December 2024 in PubMed, MEDLINE, and Embase. An Artificial Intelligence (AI)-enhanced platform was used to facilitate the review process. After the AI platform was trained on the first 50 title/abstract screenings, the remainder of the title/abstract screenings were conducted with one human and one AI screener that provided reviewer-level decisions, with adjudication by another independent human. Full texts were dual screened by independent human reviewers.
RESULTS: 27,040 publications were identified on Embase and PubMed. After de-duplication, 18,759 publications were reviewed. Title/abstract screening and full-text review yielded 135 publications that reported GAD as a comorbidity of other conditions. Common comorbidities included other psychiatric disorders (e.g., major depressive disorder, substance use disorder) as well as non-neuropsychiatric conditions (e.g., inflammatory bowel disease, chronic pain). Twenty publications reported that GAD occurring as a comorbidity that worsens patient outcomes. This includes higher risk of complications, lower remission rates, and increased healthcare resource utilization/costs (e.g., inpatient visits and medication expenses, etc.).
CONCLUSIONS: This review sheds light on the impact of GAD and its association and possible mechanistic overlap between GAD and comorbid psychiatric disorders. Based on this review, GAD is associated with worsened outcomes in various psychiatric and medical conditions, which can lead to increased HCRU directly associated with GAD and with comorbidities. This underscores the need for improved GAD interventions, in some cases with the context of comorbid disease burden.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO241
Topic
Clinical Outcomes, Methodological & Statistical Research, Study Approaches
Topic Subcategory
Relating Intermediate to Long-term Outcomes
Disease
Gastrointestinal Disorders, Mental Health (including addition), Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)