Generalized Anxiety Disorder Epidemiology: Findings from Claims Analysis and a Systematic Literature Review

Objectives: Generalized anxiety disorder (GAD) is associated with considerable health and economic burden, yet contemporary US epidemiologic estimates remain limited and inconsistent. This study aimed to generate updated prevalence estimates using real-world data and to contextualize findings through a systematic literature review.

Methods: We used closed claims data from the Komodo Healthcare Map™ database to estimate annual and multi-year incidence and prevalence rates of GAD in US adults (2021-2023). Patients were identified using ICD-10 diagnosis codes and GAD-related pharmacological treatment codes, with continuous enrollment required. Estimates were adjusted for payer, gender, and age. A parallel systematic literature review identified US GAD epidemiology studies published in English from 2014 to 2024 in PubMed, MEDLINE, and Embase.

Results: In 2023, 1-year GAD prevalence among US adults was 6.6% (16.4M). The 3-year prevalence (2021-2023) was 10.6% of the US adult population (25.3M). Patients were predominantly female (67.4%), middle-aged (mean age: 43.7), and commercially insured (60.6%). In contrast, population surveys (2014-2017) reported 1-year prevalence estimates from 1.36% to 1.8%. Studies of estimated self-reported prevalence of GAD (i.e., 17.2%) far exceeded interview-based (2.8%) GAD prevalence rates.

Conclusion:. This study provides real-world estimates of recent GAD prevalence among US adults. Over one in ten adults experience GAD over a three year period, reflecting an under-reporting in survey-based data. Our results suggest that cross- national prevalence of GAD may need to be reassessed as the true burden of GAD may be considerably greater than previously estimated.