Presentation (CTI)

OBJECTIVES: Generalized anxiety disorder (GAD) and major depressive disorder (MDD) frequently co-occur, but the clinical burden associated with their comorbidity is not well characterized. This study compared patient-reported symptom severity among individuals with GAD, MDD, and co-occurring GAD and MDD.
METHODS: This retrospective analysis used US claims data (Komodo; 2022-2024) linked to GAD-7/PHQ-9 scores in electronic health records. The index date was the first encounter with a GAD or MDD diagnosis in 2024. Patients were classified as GAD without MDD (GAD), MDD without GAD (MDD), and co-occurring GAD and MDD (GAD+MDD). Demographics and clinical characteristics were assessed over a 12-month lookback period. PHQ-9 and GAD-7 scores captured within ±1 year of index were analyzed using the assessment closest to index when multiple were available.
RESULTS: Cohorts included GAD (n=991,306), GAD+MDD (n=927,476), and MDD (n=1,436,078). Patients with GAD and GAD+MDD were relatively younger (~46 years) than those with MDD (~57 years). Medicare coverage was most common in MDD (47%), whereas commercial insurance predominated in GAD (60%). Patients with GAD+MDD had the highest symptom severity, as reflected by a greater proportion of patients with severe anxiety (GAD-7 ≥15; 26% vs 16% in GAD and 12% in MDD) and severe depressive symptoms (PHQ-9 ≥20; 8% vs 2% in GAD and 5% in MDD). The GAD+MDD cohort also had the highest proportion of patients with moderate to severe anxiety (GAD-7 scores 10-21: 48% vs 32% in GAD and 30% in MDD) and moderate to severe depressive symptoms (PHQ-9 scores 10-27: 38% vs 16% in GAD and 26% in MDD).
CONCLUSIONS: Patients with co-occurring GAD and MDD reported substantially greater symptom anxiety and depressive symptom severity than those with either disorder alone, identifying a subgroup with increased disease burden.