Ideally, the clinical goal for individuals with a history of anxiety disorder is not only to remit from the disorder, but also to reach optimal well-being. This broader concept of recovery aligns with Keyes’ concept of complete mental health (CMH), including presence of happiness or life satisfaction, and social and psychological wellbeing, and absence of any past year mental illness including anxiety disorders, depressive disorders, substance dependence and suicidal ideation. This study’s aim was to identify factors associated with CMH in a populationbased sample of Canadians with a previous diagnosis of Generalized Anxiety Disorder (GAD) (n = =2128), of whom 40% are currently in CMH. Data were from the 2012 Canadian Community Health Survey-Mental Health (response rate=68.9%). The World Health Organization version of the Composite International Diagnostic Interview (WHOeCIDI) scales were used to define lifetime and past-year GAD. Factors associated with complete mental health include female gender, older age, being married, reporting good to excellent physical health, being free of chronic insomnia, being able to manage household activities without difficulties, using religion or spirituality to cope, having a confidant, and never having had a major depressive disorder nor substance dependence. Results of this study suggest many with a history of anxiety disorders can achieve CMH and point to factors that appear to facilitate this process.
Anxiety disorders affect 12% of the Canadian population (Public Health Agency of Canada., 2014). In comparison to the general population, individuals with anxiety disorders are more likely to be divorced, unemployed, obese or substance abusers (Greenberg et al., 1999). Anxiety disorders are also associated with twice the risk of subsequent onset of suicidal ideation and three times the risk of suicide attempts (Sareen et al., 2005). The economic costs of anxiety disorders are substantial due to workplace productivity loss and health care expenses (Greenberg et al., 1999).
Given the high burden of anxiety disorders, there is a great deal of interest in factors associated with remission from anxiety (Destoop et al., 2013; Iancu et al., 2014). The ideal goal, however, would be to help patients not only remit, but also be fully engaged in and enjoying life. This concept, termed “complete mental health”, has been used increasingly in the literature (Fuller-Thomson et al., 2016; Baiden and Fuller-Thomson, 2016; Keyes, 2002; Keyes, 2005). Complete mental health is defined as the state of having both the presence of positive mental health (i.e. feeling good about oneself, one’s relationships with others, one’s connections to community or society and being able to function well in daily activities) and the absence of current mental illness (Gilmour, 2014; Keyes, 2009). Incomplete mental health is associated with increased burden of disease, limitations in activities and ability to work, healthcare utilization, and mortality (Keyes and Grzywacz, 2005; Keyes, 2005, 2004).