"Differences among patients with each anxiety disorder and those with no anxiety disorder were most marked for the SF-20 domains that previous studies have shown are most strongly related to mental disorders -- that is, mental health, followed by social, overall general health, and role functioning, with a lesser relationship to pain and physical functioning," they wrote.
Impairment associated with each disorder increased significantly as the number of anxiety disorders increased (P < 0.001), they noted.
When they evaluated the GAD-7 screening instrument, the authors found that it had high sensitivity and good specificity for detecting the four anxiety disorders.
"The comorbidity that anxiety disorders share with one another, as well as with depressive and somatic symptoms, is noteworthy," Dr. Kroenke and colleagues wrote. "This three-way relationship among anxiety, depression, and somatic symptoms is well established. Anxiety disorders also frequently occur in patients with chronic medical disorders and increase the disability of such patients. Recognizing the potentially treatable anxiety or depressive disorders that are highly concurrent with somatic symptoms or medical comorbid conditions is therefore important."