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Generalized anxiety disorder (GAD) is a chronic and highly comorbid illness characterized by excessive and uncontrollable worry (Box 19-). It is marked by a later onset than other anxiety disorders (Kessler et al. 2005) and is associated with fluctuations in symptom severity and impairment (e.g., Wittchen et al. 2000). It demonstrates both a low probability of recovery (32%–58%) and a high likelihood of recurrence (45%–52%) (Rodriguez et al. 2006) over a 2- to 12-year period. GAD is associated with significant disability and impairment comparable to pure major depressive disorder (Hoffman et al. 2008) and can be more debilitating than pure substance use disorders, some anxiety disorders, and personality disorders, even after controlling for sociodemographic variables and comorbid conditions (Grant et al. 2005).
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