Impact of generalized social anxiety disorder in managed care

David J Katzelnick, K. A. Kobak, T. Deleire, H. J. Henk, J. H. Greist, J. R T Davidson, F. R. Schneier, M. B. Stein, C. P. Helstad

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

Objective: The authors determined the costs associated with generalized social anxiety disorder in a managed care setting. Method: A three-phase mail and telephone survey was conducted from July to October 1998 in two outpatient clinics of a large health maintenance organization (HMO). The survey assessed direct costs, indirect costs, health-related quality of life, and clinical severity associated with generalized social anxiety disorder, both alone and with comorbid psychopathology. Results: The weighted prevalence rate of current generalized social anxiety disorder was 8.2%. In the past year, only 0.5% of subjects with generalized social anxiety disorder had been accurately diagnosed. Yet 44.1% had a mental health specialty visit or had been prescribed an antidepressant, and psychiatric comorbidity was found in 43.6%. Noncomorbid generalized social anxiety disorder was associated with significantly lower health-related quality of life, work productivity, and earnings and greater utilization of health services; generalized social anxiety disorder with comorbid psychopathology was even more disabling. Suicide was attempted by 21.9% of subjects with noncomorbid generalized social anxiety disorder. Persons with average-severity generalized social anxiety disorder had probabilities of graduating from college that were 10 percentage points lower, earned wages that were 10% lower, and had probabilities of holding a technical, professional, or managerial job that were 14 percentage points lower than the comparison group. Conclusions: In a community cohort of HMO members, generalized social anxiety disorder was rarely diagnosed or treated despite being highly prevalent and associated with significant direct and indirect costs, comorbid depression, and impairment.

Original languageEnglish (US)
Pages (from-to)1999-2007
Number of pages9
JournalAmerican Journal of Psychiatry
Volume158
Issue number12
DOIs
StatePublished - 2001
Externally publishedYes

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Managed Care Programs
Costs and Cost Analysis
Health Maintenance Organizations
Psychopathology
Quality of Life
Social Phobia
Attempted Suicide
Salaries and Fringe Benefits
Postal Service
Ambulatory Care Facilities
Telephone
Antidepressive Agents
Health Services
Psychiatry
Comorbidity
Mental Health
Depression

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Katzelnick, D. J., Kobak, K. A., Deleire, T., Henk, H. J., Greist, J. H., Davidson, J. R. T., ... Helstad, C. P. (2001). Impact of generalized social anxiety disorder in managed care. American Journal of Psychiatry, 158(12), 1999-2007. https://doi.org/10.1176/appi.ajp.158.12.1999

Impact of generalized social anxiety disorder in managed care. / Katzelnick, David J; Kobak, K. A.; Deleire, T.; Henk, H. J.; Greist, J. H.; Davidson, J. R T; Schneier, F. R.; Stein, M. B.; Helstad, C. P.

In: American Journal of Psychiatry, Vol. 158, No. 12, 2001, p. 1999-2007.

Research output: Contribution to journalArticle

Katzelnick, DJ, Kobak, KA, Deleire, T, Henk, HJ, Greist, JH, Davidson, JRT, Schneier, FR, Stein, MB & Helstad, CP 2001, 'Impact of generalized social anxiety disorder in managed care', American Journal of Psychiatry, vol. 158, no. 12, pp. 1999-2007. https://doi.org/10.1176/appi.ajp.158.12.1999
Katzelnick, David J ; Kobak, K. A. ; Deleire, T. ; Henk, H. J. ; Greist, J. H. ; Davidson, J. R T ; Schneier, F. R. ; Stein, M. B. ; Helstad, C. P. / Impact of generalized social anxiety disorder in managed care. In: American Journal of Psychiatry. 2001 ; Vol. 158, No. 12. pp. 1999-2007.
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