Journal
ACTA PSYCHIATRICA SCANDINAVICA
Volume 128, Issue 3, Pages 212-221Publisher
WILEY
DOI: 10.1111/acps.12024
Keywords
anxiety disorder; panic disorder; social phobia; generalized anxiety disorder; course; anxiety arousal; avoidance behaviour
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Funding
- Netherlands Organization for Health Research and Development (Zon-Mw) [10-000-1002]
- VU University Medical Center
- GGZ inGeest
- Arkin
- Leiden University Medical Center
- GGZ Rivierduinen
- University Medical Center Groningen
- Lentis
- GGZ Friesland
- GGZ Drenthe
- Scientific Institute for Quality of Healthcare (IQ healthcare)
- Netherlands Institute for Health Services Research (NIVEL)
- Netherlands Institute of Mental Health and addiction (Trimbos)
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Objective: This study compares diagnostic and symptom course trajectories across different anxiety disorders, and examines the role of anxiety arousal vs. avoidance behaviour symptoms in course prediction. Method: Data were from 834 subjects with a current anxiety disorder from the Netherlands Study of Depression and Anxiety (NESDA) who were re-interviewed after 2 years. DSM-IV-based diagnostic interviews and Life Chart Interviews (LCI) were used to assess the diagnostic and symptom course trajectory over 2 years. Anxiety arousal and avoidance behaviour symptoms were measured with LCI, Beck Anxiety Inventory and Fear Questionnaire. Results: Prognosis varied across disorders, with favourable remittance rates of 72.5% for panic disorder without agoraphobia and 69.7% for generalized anxiety disorder; gradually declining to 53.5% for social phobia and 52.7% for panic disorder with agoraphobia. Only 42.9% of those with multiple anxiety disorder remitted, and this group showed a more chronic course than pure anxiety disorders. Both baseline duration and severity were course predictors. Avoidance behaviour symptoms predicted the outcome better than anxiety arousal symptoms. Conclusions: These data suggest that the specific anxiety disorders such as recognized by DSM-IV are useful in predicting the outcome and that this may be determined largely by the relative severity of avoidance behaviour that patients have developed.
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