Abstract
Objective:Little is known about the course of anxiety disorders in the general population. This study provides insights into the course of anxiety disorders in the general population taking into account transition to residual symptoms and to other diagnostic categories.Methods:Using data from three waves of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; n = 6646), subjects with anxiety disorders (T0; n = 243) were divided into three mutually exclusive course trajectories according to their diagnostic status at 3-year (T1) and 6-year (T2) follow-up: remission group (no disorder at T2), intermittent course group (no disorder at T1 and disorder at T2) and chronic course group (disorder at all measurements). Transition to residual symptoms or other psychopathology were studied. In addition, predictors of course trajectories were assessed.Results:During 6-year follow-up, 77.8% of subjects achieved remission, 14.0% followed an intermittent course and 8.2% a chronic course. Of those in remission, residual anxiety symptoms remained in 46.6%, while 7.9% developed another disorder between T0 and T2. Compared with the remitting group, a chronic course was predicted by not living with a partner, multiple negative life events, neuroticism, lower mental functioning, severity of anxiety symptoms, use of mental health care and medication use.Limitations:The intermittent and chronic course groups were small, limiting statistical power. As a result, certain predictors may not have reached significance.Conclusions:In the general population at 6-year follow-up, 77.8% of subjects with anxiety disorders achieved remission. Because of transition to residual symptoms or another diagnostic category, only 52.4% of those subjects had a true favourable outcome.
Highlights
Anxiety disorders have major implications on individual lives and society, accompanied by significant personal and societal costs (Remes et al, 2016; Saarni et al, 2007)
It is an addition to the literature, since, to our knowledge, this is the first study conducted on the long-term course of anxiety disorders in the general population in which transition to residual subthreshold symptoms and transition to other diagnostic groups has been taken into account
Our findings corroborate the view that the course of anxiety disorders is more favourable in the general population as compared with clinical-based populations, which generally report lower remission rates, such as 58.4 % remission at 2-year follow-up (Spinhoven et al, 2011) and 32–55% remission at 12-year follow-up (Bruce et al, 2005)
Summary
Anxiety disorders have major implications on individual lives and society, accompanied by significant personal and societal costs (Remes et al, 2016; Saarni et al, 2007). The course of anxiety disorders is characterized by fluctuating symptom levels (Batelaan et al, 2014), high relapse rate following remission (Ansell et al, 2011) and chronicity (Spinhoven et al, 2016). May reduce quality of life (Haller et al, 2014), are associated with a decreased level of functioning (Batelaan et al, 2007a; Bosman et al, 2019; Fehm et al, 2008) and are accompanied by high costs due to medical costs and absenteeism (Batelaan et al, 2007b). More than half of the patients (54.8%) fulfilled criteria of an anxiety or depressive disorder (Scholten et al, 2016)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
