Generalised anxiety and panic symptoms in the German National Cohort (NAKO)

Abstract

Objectives

Anxiety disorders (AD) are common in the general population, leading to high emotional distress and disability. The German National Cohort (NAKO) is a population-based mega-cohort study, examining participants in 16 German regions. The present study includes data of the first 101,667 participants and investigates the frequency and severity of generalised anxiety symptoms and panic attacks (PA).

Methods

The Generalised Anxiety Disorder Symptoms Scale (GAD-7) and the first part of the Patient Health Questionnaire Panic Disorder (PHQ-PD) were filled out by NAKO participants (93,002). We examined the correlation of GAD-7 and PHQ-PD with demographic variables, stress (PHQ-Stress), depression (PHQ-9) and childhood trauma (CTS).

Results

The total proportion of prior lifetime diagnoses of AD in the NAKO cohort reached 7.8%. Panic attacks were reported by 6.0% and possible/probable current GAD symptoms in 5.2% of the examined participants. Higher anxiety severity was associated with female sex, lower education level, German as a foreign language and younger age as well as high perceived stress and depression.

Conclusions

Clinically relevant GAD symptoms as well as panic attacks are frequent in the NAKO and are associated with sociodemographic factors, and high anxiety symptoms are accompanied by pronounced stress and depression levels.

Keywords:

• Generalised anxiety
• panic attacks
• GAD-7
• PHQ-Panic
• German National Cohort

Acknowledgements

We thank all study participants and staff at the NAKO study centres, the data management and integration centre, and the NAKO head office who enabled the conduction of the study and made the collection of all data possible. We also thank other members of the Neuropsychiatry Group within the NAKO under the leadership of Klaus Berger for the conception of the neuropsychiatric evaluation.

Statement of interest

H.J. Grabe has received travel grants and speaker honoraria from Fresenius Medical Care, Neuraxpharm, Servier and Janssen Cilag as well as research funding from Fresenius Medical Care. J. Deckert is the co-recipient of a grant of the Bavarian State Government to BioVariance and an investigator in a European grant to P1Vital.

The following authors declare no conflicts of interest: A. Erhardt, G. Gelbrich, A. Führer, R. Mikolajczyk, C.O. Schmidt, S. Ostrzinski, W. Lieb, J. Fricke, H. Greiser and K. Berger.

Additional information

Funding

The German National Cohort (NAKO) (www.nako.de) is funded by the Federal Ministry of Education and Research [project numbers: 01ER1301A/B/C and 01ER1511D], the federal states and the Helmholtz Association, with additional financial support from the participating universities and the participating institutes of the Leibniz Association and the Helmholtz Association.F. Streit and M. Rietschel were supported by the German Federal Ministry of Education and Research (BMBF) through ERA-NET NEURON, ‘SynSchiz – Linking synaptic dysfunction to disease mechanisms in schizophrenia – a multilevel investigation’ [01EW1810 to MR], through ERA-NET NEURON ‘Impact of Early life MetaBolic and psychosocial strEss on susceptibility to mental Disorders; from converging epigenetic signatures to novel targets for therapeutic intervention’ [01EW1904 to MR].