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Generalized anxiety disorder: a 40-year follow-up study
1Retiro Mental Health Centre; and Psychiatry Department, Complutense University of Madrid, Madrid, Spain. garuva@inicia.es
Acta Psychiatrica Scandinavica
|April 14, 2007
Summary
Generalized anxiety disorder (GAD) often improves over decades, though somatization disorders may emerge. Factors like poor treatment adherence and early onset are linked to worse outcomes in GAD patients.
Area of Science:
- Psychiatry
- Longitudinal Studies
- Anxiety Disorders
Background:
- Generalized anxiety disorder (GAD) is a common condition with limited understanding of its long-term prognosis.
- Longitudinal data on GAD course is crucial for effective treatment strategies and patient management.
Purpose of the Study:
- To investigate the long-term course of generalized anxiety disorder (GAD) over a 40-year follow-up period.
- To identify factors associated with the prognosis and outcome of GAD.
Main Methods:
- Retrospective diagnosis of GAD using DSM-III-R criteria in patients initially admitted for anxiety states between 1950-1961.
- Two-phase examination of 65 patients (first 1984-1988, second 1997-2001) to assess GAD persistence and outcomes.
Main Results:
- GAD diagnosis was confirmed in 20% and 17% of subjects at first and second examinations, respectively.
- Significant improvement in GAD symptoms was observed in 83% of participants.
- GAD tended to remit around age 50, often replaced by somatization disorders; poor treatment compliance, female sex, and early onset (before 25) predicted worse outcomes.
Conclusions:
- Long-term follow-up indicates that individuals with GAD generally show improvement over several decades.
- Despite GAD symptom improvement, a substantial proportion of patients continue to experience somatization disorders.
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