Health-related quality of life and economic burden associated with likely and diagnosed generalized anxiety disorder among the US general adult population

BACKGROUND: Generalized anxiety disorder (GAD) remains widely underdiagnosed. The impact of GAD on adults who are likely to have GAD but are undiagnosed is not well understood. This study compared health-related quality of life (HRQoL) and economic burden among US adults with likely GAD, diagnosed GAD, and no GAD. METHODS: A retrospective, cross-sectional observational study was conducted using data from the 2022 US National Health and Wellness Survey (N = 75,261 adults). Key outcomes included HRQoL, work productivity loss, activity impairment, healthcare resource utilization, and direct and indirect healthcare costs. Covariates included demographics, health characteristics, and comorbidities. Generalized linear models were used to compare outcome variables across adults with likely GAD, diagnosed GAD, and no GAD. RESULTS: Compared with the others, adults with likely GAD who were undiagnosed were younger, more likely to be male, Hispanic, employed, and had the highest household income, but were less likely to have health insurance. They were also more likely to have undiagnosed depression. Adults with likely GAD experienced significantly lower HRQoL, greater work productivity loss, activity impairment, emergency room visits, hospitalizations, and healthcare costs (both direct and indirect), than those with diagnosed GAD. Adults with GAD-whether likely and undiagnosed or diagnosed-had significantly lower HRQoL and higher work productivity loss, activity impairment, healthcare resource use, and healthcare costs than those without GAD. CONCLUSIONS: GAD, especially likely GAD without a diagnosis, significantly impacts HRQoL and economic burden among US adults. This study's results suggest the need for increased efforts to improve detection and diagnosis of GAD and to direct patients to appropriate care.