Chronic anxiety and social adjustment

Abstract

Anxiety disorders have a favorable long-term prognosis. In a review of literature, Greer 1 found that half of the examined cases had a satisfactory outcome. More recently, Noyes et al. 2 reported that 68% of patients who had originally been seen in medical clinics and were diagnosed “anxiety neurosis,” either recovered or were only mildly impaired 6 years later. Less known are factors that are responsible or are related to improvement. Noyes et al. 2 found poor outcome related to higher age, longer duration of their illness, and membership in lower socio-economic class. Rickels. 3 who studied effects of anxiolytic drugs on anxiety disorders, reported better results in patients with high initial symptomatology, low obsessive-compulsiveness, and fewer interpersonala and depressive components. He also reported a positive relationship between high socio-economic status and outcome. In unselected “neurotic” outpatients, many of them suffering from anxiety disorders, favorable outcome was associated with positive personality assets, 4 high levels of stress at the onset of illness, 4 high initial severity ratings, 3 and with positive ratings of the quality of social life at the time of the follow-up. 5 Mann et al. 5 proposed a triaxial assessment and classification of nonpsychotic psychiatric disorders, in which symptoms, personality, and social states, are evaluated independently. Following their suggestions, we examined changes in a group of chronically anxious patients as they occurred 6–37 months after the initial evaluation.