The adjustment to illness in patients with generalized anxiety disorder is poorer than that in patients with end-stage renal disease

Although generalized anxiety disorder (GAD) is associated with significant occupational disability, it has, however, received little attention with regard to adjustment to illness. Subjects included 102 chronic dialysis (CD) patients, 58 kidney transplant (KT) patients, and 42 GAD patients. The evaluations included the Psychosocial Adjustment to Physical Illness Scale (PAIS), the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D). Preanxiolytic treatment GAD patients had the most anxiety and depressive symptoms, followed by CD patients and KT patients. KT patients and anxiolytic-treated GAD patients showed similar anxiety and depressive symptoms. These two groups were both better than CD patients. However, the adjustment to illness of GAD patients after treatment is still worse than the other two groups (108.0 +/- 16.3(GAD), 102.0 +/- 14.5(CD), 81.4 +/- 22.2(KT); P<.001). The CD patients had a high rate of psychiatric morbidity and a low rate of psychiatric intervention (3%); however, end-stage renal disease (ESRD) patients received only one assessment while the GAD group received two in this study. In light of the chronicity of GAD, pharmacological treatment is not sufficient by itself. Clinicians should keep these in mind when treating either GAD or ESRD. (C) 2004 Elsevier Inc. All rights reserved.