Am J Psychiatry 162:1179-1187, June 2005
© 2005 American Psychiatric Association
Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12-Year Prospective Study
Steven E. Bruce, Ph.D.,
Kimberly A. Yonkers, M.D.,
Michael W. Otto, Ph.D.,
Jane L. Eisen, M.D.,
Risa B. Weisberg, Ph.D.,
Maria Pagano, Ph.D.,
M. Tracie Shea, Ph.D., and
Martin B. Keller, M.D.
OBJECTIVE: The authors sought to observe the long-term clinical course of anxiety disorders over 12 years and to examine the influence of comorbid psychiatric disorders on recovery from or recurrence of panic disorder, generalized anxiety disorder, and social phobia. METHOD: Data were drawn from the Harvard/Brown Anxiety Disorders Research Program, a prospective, naturalistic, longitudinal, multicenter study of adults with a current or past history of anxiety disorders. Probabilities of recovery and recurrence were calculated by using standard survival analysis methods. Proportional hazards regression analyses with time-varying covariates were conducted to determine risk ratios for possible comorbid psychiatric predictors of recovery and recurrence. RESULTS: Survival analyses revealed an overall chronic course for the majority of the anxiety disorders. Social phobia had the smallest probability of recovery after 12 years of follow-up. Moreover, patients who had prospectively observed recovery from their intake anxiety disorder had a high probability of recurrence over the follow-up period. The overall clinical course was worsened by several comorbid psychiatric conditions, including major depression and alcohol and other substance use disorders, and by comorbidity of generalized anxiety disorder and panic disorder with agoraphobia. CONCLUSIONS: These data depict the anxiety disorders as insidious, with a chronic clinical course, low rates of recovery, and relatively high probabilities of recurrence. The presence of particular comorbid psychiatric disorders significantly lowered the likelihood of recovery from anxiety disorders and increased the likelihood of their recurrence. The findings add to the understanding of the nosology and treatment of these disorders.
This article has been cited by other articles:
|
|
|
|
 
B. A. Marcks and R. B. Weisberg
Co-occurrence of Insomnia and Anxiety Disorders: A Review of the Literature
American Journal of Lifestyle Medicine,
July 1, 2009;
3(4):
300 - 309.
[Abstract]
[PDF]
|
|
|
|
|
|
|
B. A. Marcks, R. B. Weisberg, and M. B. Keller
Psychiatric Treatment Received by Primary Care Patients With Panic Disorder With and Without Agoraphobia
Psychiatr Serv,
June 1, 2009;
60(6):
823 - 830.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Montgomery, K. Chatamra, L. Pauer, E. Whalen, and F. Baldinetti
Efficacy and safety of pregabalin in elderly people with generalised anxiety disorder
The British Journal of Psychiatry,
November 1, 2008;
193(5):
389 - 394.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Bibliography Panic and Social Anxiety Disorder
Focus,
October 1, 2008;
6(4):
459 - 461.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. M. Rapee, M. J. Abbott, A. J. Baillie, and J. E. Gaston
Treatment of social phobia through pure self-help and therapist-augmented self-help
The British Journal of Psychiatry,
September 1, 2007;
191(3):
246 - 252.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Gale
Escitalopram 10 mg daily is more effective than paroxetine and placebo for generalised anxiety disorder
Evid. Based Ment. Health,
May 1, 2007;
10(2):
45 - 45.
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. J. Katon
Clinical practice. Panic disorder.
N. Engl. J. Med.,
June 1, 2006;
354(22):
2360 - 2367.
[Full Text]
[PDF]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 2005
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
