Assessment of Dysautonomia (Autonomic Dysfunction) in Patients of GAD: A Cross-sectional Study

Background: Generalized anxiety disorder (GAD) is a chronic and disabling psychiatric condition associated with increased autonomic dysfunction and cardiovascular risk.Autonomic dysfunction, characterized by dysregulation of the autonomic nervous system, is increasingly recognized as a key factor in GAD pathophysiology.This study aimed to assess autonomic dysfunction in GAD patients using the Composite Autonomic Symptom Score (COMPASS-31).Materials and methods: A cross-sectional study was conducted during the month of December 2024 at ICARE Institute of Medical Sciences and Research and Dr Bidhan Chandra Roy Hospital, Haldia.The study included 100 participants (50 GAD patients and 50 healthy controls) aged 18-45 years.The GAD diagnosis was based on International Classification of Diseases, Tenth Revision criteria.Autonomic dysfunction was assessed using COMPASS-31, and anxiety severity was evaluated using the GAD-7 scale.Data were analyzed using Statistical Package for Social Sciences, with statistical significance set at p < 0.05.Results: The GAD patients exhibited significantly higher COMPASS-31 scores (27.84 7.02) compared with healthy controls (9.12 4.64, p < 0.01).The orthostatic domain showed the highest score among GAD patients (10.82 4.02, p < 0.01), followed by gastrointestinal dysfunction (7.96 3.44, p < 0.02).Elevated systolic and diastolic blood pressures were observed in GAD patients (126.12 6.02 mm Hg and 84.06 9.58 mm Hg, respectively) compared with controls.Regression analysis revealed a positive correlation between GAD severity and COMPASS-31 scores, with moderate-to-severe GAD significantly associated with higher autonomic dysfunction scores. Conclusion:This study highlights significant autonomic dysfunction in GAD patients, emphasizing the role of the autonomic nervous system in GAD pathophysiology.The COMPASS-31 questionnaire proved to be a useful screening tool for autonomic dysfunction in this population.Future research should explore interventions targeting autonomic regulation to improve clinical outcomes in GAD.