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The Social Costs of Anxiety Disorders
Open accessAbstract
BACKGROUND: The social costs of anxiety disorders, which afflict a substantial proportion of the general population in the United States, are considered. METHOD: Data from the National Institute of Mental Health (NIMH) Epidemiological Catchment Area Program were analysed. RESULTS: Over 6% of men and 13% of women in the sample of 18,571 had suffered from a DSM-III anxiety disorder in the past six months. Nearly 30% of those with panic disorder had used the general medical system for emotional, alcohol or drug-related problems in the six months prior to the interview. Those with anxiety disorders were also more likely to seek help from emergency rooms and from the specialised mental health system. Men with panic disorder, phobias or obsessive-compulsive disorder in the previous six months are more likely to be chronically unemployed and to receive disability or welfare. DISCUSSION: Once correctly diagnosed there are safe and effective psychopharmacologic and behavioural treatments for the anxiety disorders. Nevertheless the burden of anxiety disorders extends beyond the direct costs of treatment to the indirect costs of impaired social functioning.
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“Patients with anxiety disorder use many primary care and accident and emergency resources C40Leon et al , 1995)”
From Reducing demands on clinicians by offering computer-aided self-help for phobia/panic: Feasibility study (2001) · cites this paper as Leon et al, 1995
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Dozois, D. J. A., & Westra, H. A. (2004) · American Psychological Association eBooks · doi:10.1037/10722-002 · Cited by 56
Costs and Cost-Effectiveness of Family CBT Versus Individual CBT in Clinically Anxious Children
Bodden, D. H. M., Dirksen, C. D., Bögels, S. M., Nauta, M. H., de Haan, E., Ringrose, J., Appelboom, C., Brinkman, A. G., & Appelboom-Geerts, K. C. M. M. J. (2008) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104508090602 · Cited by 58
“The expected long-term benefits for society concern lower crime rates, less alcohol and drug abuse, lower social care usage, better earning potential for the child, less unemployment of the child as an adult, and lower healthcare usage (Greenberg et al., 1999; Knapp, 1997; Leon et al., 1995; Marciniak, Lage, Landbloom…”
BackgroundFarrell, L. J., Barrett, P. M., & Piacentini, J. C. (2006) · Behaviour Change · doi:10.1375/bech.23.2.103 · Cited by 55
“OCD in adulthood is frequently associated with impairment in general functioning, with disruptions to gain-ful employment (Leon, Portera, & Weissman, 1995), as well as marital and interpersonal difficulties (Emmelkamp, de Hann, & Hoogduin, 1990; Riggs, Hiss, & Foa, 1992).”
Obsessive–compulsive tendencies are associated with a focused information processing strategy
Soref, A., Dar, R., Argov, G., & Meiran, N. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2008.09.001 · Cited by 55
Deckersbach, T., Peters, A. T., Sylvia, L., Urdahl, A., Magalhães, P. V. S., Otto, M. W., Frank, E., Miklowitz, D. J., Berk, M., Kinrys, G., et al. (2014) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.13020225 · Cited by 65
Human and Economic Burden of GAD, Subthreshold GAD, and Worry in a Primary Care Sample
Kertz, S. J., & Woodruff‐Borden, J. (2011) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-011-9248-1 · Cited by 55
“A failure to find significant differences between the GAD group and the nonworried group was especially surprising and contradictory to a large body of work (Hoffman et al., 2008; Leon et al., 1995; Massion et al., 1993; Roy-Byrne & Wagner, 2004).”
ResultVogel, P. A., Launes, G., Moen, E. M., Solem, S., Hansen, B., Håland, Å. T., & Himle, J. A. (2012) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.10.009 · Cited by 51
A Review of the Diagnosis, Pharmacologic Treatment, and Economic Aspects of Anxiety Disorders
Arikian, S. R., & Gorman, J. M. (2001) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.v03n0302 · Cited by 53
Boschen, M. J., Drummond, L. M., Pillay, A., & Morton, K. (2009) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2009.10.006 · Cited by 52
Physical Illness as an Outcome of Chronic Anxiety Disorders
Bowen, R., Senthilselvan, A., & Barale, A. (2000) · The Canadian Journal of Psychiatry · doi:10.1177/070674370004500506 · Cited by 49
Anxiety Disorders Among Older Primary Care Patients
Stanley, M. A., ROBERTS, R. E., Bourland, S. L., & Novy, D. M. (2001) · Journal of Clinical Geropsychology · doi:10.1023/a:1009533621832 · Cited by 51
Andrews, G., Corry, J., Browne, M. A. O., & Shepherd, L. (2003) · Australian & New Zealand Journal of Psychiatry · Cited by 48
Boschen, M. J., Drummond, L. M., & Pillay, A. (2008) · CNS Spectrums · doi:10.1017/s1092852900017119 · Cited by 48
Quality of Life and its Correlates in Patients With Obsessive‐compulsive Disorder
Hou, S., Yen, C., Huang, M., Wang, P., & Yeh, Y. (2010) · The Kaohsiung Journal of Medical Sciences · doi:10.1016/s1607-551x(10)70065-6 · Cited by 46
Otto, M. W., Tolin, D. F., Nations, K. R., Utschig, A. C., Rothbaum, B. O., Hofmann, S. G., & Smits, J. A. J. (2012) · Depression and Anxiety · doi:10.1002/da.21910 · Cited by 54
Treating panic disorder in primary care: a collaborative care intervention.
Craske, M., Roy-Byrne, P., Stein, M., Donald-Sherbourne, C., Bystritsky, A., Katon, W., & Sullivan, G. (2002) · General Hospital Psychiatry · doi:10.1016/s0163-8343(02)00174-3 · Cited by 48
“5 to 13%, with a median of 4 to 6% [11–13].”
Evidence-based pharmacotherapy of panic disorder
Bakker, A., van Balkom, A. J. L. M., & Stein, D. J. (2005) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145705005201 · Cited by 43
Impact of social anxiety disorder on employment among women receiving welfare benefits
Tolman, R. M., Himle, J., Bybee, D., Abelson, J. L., Hoffman, J., & Van Etten-Lee, M. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.1.61 · Cited by 43
The 2-year prognosis of panic episodes in the general population
Batelaan, N. M., de Graaf, R., Penninx, B. W. J. H., van Balkom, A. J. L. M., Vollebergh, W., & Beekman, A. T. F. (2009) · Psychological Medicine · doi:10.1017/s0033291709005625 · Cited by 40
“It should be realized, however, that subjects with panic often seek help (see, for example, Leon et al. 1995).”
BackgroundKnappe, S., Beesdo‐Baum, K., & Wïttchen, H. (2010) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-010-0138-0 · Cited by 47
“SAD often hampers affected individuals from pursuing their academic achievements, leading to lower educational attainment [47, 85], impaired work-performance, underemployment and lower household-income and subsequently high levels of financial dependence and lower socio-economic status [23, 61].”
BackgroundChou, K. (2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2424 · Cited by 39
“In general population, panic disorder might also lead to medical conditions that may increase healthcare service utilization, such as emergency room visits and hospitalization (Klerman et al., 1991; Leon et al., 1995; Katon, 1996).”
BackgroundResult
Metadata
- Authors
- Leon, A. C., Portera, L., & Weissman, M. M.
- Affiliations
- Cornell University (US)
- Columbia University (US)
- Corresponding author
- Leon, Andrew C.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 1995-04
- Volume
- 166
- Issue
- S27
- Pages
- 19-22
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2764473323
- Cited by
- 335
- References
- 15
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 9 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 8 · 2019: 5 · 2018: 4 · 2017: 6 · 2016: 6 · 2015: 10 · 2014: 12 · 2013: 7 · 2012: 32
- FWCI
- 12.08
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Columbia Academic Commons (Columbia University)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- anxiety disorders, social costs, panic disorder, phobia, obsessive-compulsive disorder, unemployment, disability benefits, welfare, emergency department utilization, mental health service utilization, gender differences, social functioning, indirect costs
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Combined Modality Therapy, Cross-Sectional Studies, Disability Evaluation, Female, Health Services Misuse, Humans, Male, Middle Aged, Social Welfare, United States, Incidence, Cost of Illness
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