Generalized anxiety disorder: a 40-year follow-up study
ABSTRACT There is insufficient knowledge of the long-term course of generalized anxiety disorder (GAD). We studied the course of this disorder in patients who were followed up for 40 years.
Patients admitted with the diagnosis of anxiety states ('anxious thymopathy' ) to the Lopez Ibor Neuropsychiatric Research Institute between 1950 and 1961 were examined between 1984 and 1988 (n = 65). The retrospective diagnosis of GAD was made according to DSM-III-R criteria during 1984-1988 (first examination). A re-examination was performed by the same psychiatrist in the period 1997-2001 (n = 59; second examination).
At first and second examinations 20% and 17% of subjects were diagnosed as GAD. Improvement was observed in 83%. GAD tended to disappear around age 50, but was replaced by somatization disorders. Lack of regular treatment compliance, female sex, and onset of GAD before age 25 were variables associated with a worse outcome. Undifferentiated somatization disorder was the most prevalent clinical status at follow-up.
After several decades, participants improve with regard to GAD, although most continue to present somatizations.
05/2011; 10(5):66-66. DOI:10.1016/S1541-9800(11)70354-4
[Show abstract] [Hide abstract]
ABSTRACT: Objective To determine which clinical factors predict disability and poor quality of life in patients with generalized anxiety disorder. Methodology This was a descriptive cross-sectional study. Data were analyzed using frequencies, percentages, mean. A linear regression analysis was used to determine how demographic factors predict clinical disability and poor quality of life. Results We found that the presence of a family history of anxiety disorders, as well as higher scores on the Hamilton Depression Scale, predict a lower quality of life; unlike an older age which predicts a higher quality of life in these patients. Higher levels of disability were associated with males, a younger age, comorbid Axis II disorders, the presence of a family history of anxiety disorders, and higher scores on the Hamilton Depression Scale. Conclusions Depressive symptoms and a family history of anxiety are associated with a poor quality of life. Knowing which factors predict the quality of life and disability in patients may guide us towards a more comprehensive diagnosis and treatment approach. This means will not just treat symptoms, but will seek patients' functional recovery, which leads in turn to a better quality of life.
[Show abstract] [Hide abstract]
ABSTRACT: This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have not responded to first-line interventions. A consensus meeting involving international experts in anxiety disorders reviewed the main subject areas and considered the strength of supporting evidence and its clinical implications. The guidelines are based on available evidence, were constructed after extensive feedback from participants, and are presented as recommendations to aid clinical decision-making in primary, secondary and tertiary medical care. They may also serve as a source of information for patients, their carers, and medicines management and formulary committees.Journal of Psychopharmacology 04/2014; 28(5). DOI:10.1177/0269881114525674 · 2.81 Impact Factor