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Introduction
Anxiety disorders are one of the most common mental disorders (Kessler et al. 2005; Kadri et al. 2007), commencing early in life (Kessler et al. 2007) and following a chronic course (Antony & Stein, 2009). As anxiety disorders are associated with substantial impairment (Weiller et al. 1998) and use of primary care services (Kessler & Greenberg, 2002), up-to-date information around the burden of anxiety disorders is needed to inform decision-making in public health policy and service planning.
The Global Burden of Disease (GBD) project provides a framework for evaluating the comparative impact of disease based on composite measures of disease occurrence, mortality and disability. The original GBD 1990 study demonstrated that mental disorders, especially depression and anxiety disorders, made a substantial contribution to the global burden (Murray et al. 1996).
A new GBD study (GBD 2010) commenced in 2007 and aims to include a broader range of diseases, including mental disorders, with a greater focus on empirical data (Murray et al. 2005; Degenhardt et al. 2009). While previous GBD estimates reflected only three anxiety disorders: post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and panic disorder (Murray & Lopez, 1996), GBD 2010 will report burden for 'any' anxiety disorder inclusive of the common anxiety disorders, for example, generalized anxiety disorder, and early-onset disorders such as separation anxiety disorder (see online Supplementary Appendix A). Previously an overall estimate could not be made for anxiety disorders as the high co-morbidity between specific disorders means that prevalent cases cannot simply be summed. Whilst acknowledging that estimates for 'any' anxiety disorder will not capture the variability in individual anxiety disorders, it ensures burden is not over-estimated through 'double counting' of individuals with multiple disorders. This paper describes the review undertaken to identify global data for prevalence of anxiety disorders.
Whilst a substantial body of data is available on the epidemiology of anxiety disorders, it is highly fragmented and reported prevalence varies considerably (Marks, 1986; Weissman, 1988; Somers et al. 2006; Tanios et al. 2009). This variability presents a challenge in deriving regional burden estimates, as it is unclear the extent to which differences in prevalence estimates are real or are being influenced by cultural, methodological or other factors. In addition to...