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Phenomenology and Course of Generalised Anxiety Disorder

Published online by Cambridge University Press:  02 January 2018

Kimberly A. Yonkers*
Affiliation:
Departments of Psychiatry and Obstetrics & Gynecology, The University of Texas, Southwestern Medical Center at Dallas
Meredith G. Warshaw
Affiliation:
Brown University, Providence, RI
Ann O. Massion
Affiliation:
Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA
Martin B. Keller
Affiliation:
Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906
*
Professor Yonkers, 5959 Harry Hines Blvd., Dallas, TX 75235-9101

Abstract

Background

The diagnostic category of generalised anxiety disorder (GAD) was originally intended to describe residual anxiety states. Over the years clinical criteria have been refined in an attempt to describe a unique diagnostic entity. Given these changes, little is known about the clinical course of this newly defined disorder. This study investigates the longitudinal course, including remission and relapse rates, for patients with DSM–III–R defined GAD.

Method

Analysis of the 164 patients with GAD participating in the Harvard Anxiety Research Program. Patients were assessed with a structured clinical interview at intake and re-examined at six month intervals for two years and then annually for one to two years. Psychiatric Status Ratings were assigned at each interview point. Kaplan–Meier curves were constructed to assess likelihood of remission.

Results

Comorbidity was high, with panic disorder and social phobia as the most frequently found comorbid disorders. The likelihood of remission was 0.15 after one year and 0.25 after two years. The probability of becoming asymptomatic from all psychiatric symptoms was only 0.08.

Conclusions

This prospective study confirms the chronicity associated with GAD and extends this finding to define the one and two year remission rates for the disorder. Likelihood of remission for GAD and any other comorbid condition after one year was half the annual remission rate for GAD alone.

Type
Research Article
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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