DSM-III generalized anxiety disorder: an empirical investigation of more stringent criteria.

The diagnoses of generalized anxiety disorder (GAD) according to DSM-III and according to revised criteria (requiring 6 months' duration and 6 symptoms) were determined by the use of the National Institute of Mental Health Diagnostic Interview Schedule in a probability sample of 357 women. The DSM-III GAD lifetime rate of 45% was reduced by a factor of five when the revised definition was applied. The reduction was due chiefly to the longer duration criterion. Requiring a higher number of symptoms did not raise the threshold for the diagnosis, since 74% of persons with a period of 1 month or more of generalized anxiety reported six symptoms. Although chronicity was associated with more pervasive symptomatology, the excess in symptoms appears to be due to the very high prevalence of major depression (73%) among the newly defined (i.e., chronic) GAD positives.