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Factors predicting the clinical course of generalised anxiety disorder
K A Yonkers1, I R Dyck, M Warshaw
1Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, USA. Kim.Charlie@worldnet.att.net
Background:
Cross-sectional data show that generalised anxiety disorder (GAD) is a chronic condition with episodes lasting much longer than the six-month minimum required by DSM-III-R and DSM-IV. Although GAD is chronic, little is known about factors influencing illness duration.
Aims:
To investigate variables that influence the clinical course of GAD.
Method:
A total of 167 patients with GAD participated in the Harvard-Brown Anxiety Research Program. Patients were assessed at intake and re-examined at six- to twelve-month intervals for five years. Kaplan-Meier curves were constructed to assess the likelihood of remission. Regression analysis was used to investigate factors predicting full or partial remission.
Results:
The rate of remission was 0.38 after five years. Diminished likelihood of remission was associated with low overall life satisfaction, poor spousal or family relationships, a concurrent cluster B or C personality disorder and a low global assessment score.
Conclusions:
Full or partial remissions were less likely to occur in patients with poor relationships and personality disorders. These patients should be given more intensive and possibly multi-modal therapy.