title: Two-year course of depressive and anxiety disorders: results from the Netherlands Study of Depression and Anxiety (NESDA).
abstract: BACKGROUND
  Whether course trajectories of depressive and anxiety disorders are different, remains an important question for clinical practice and informs future psychiatric nosology. This longitudinal study compares depressive and anxiety disorders in terms of diagnostic and symptom course trajectories, and examines clinical prognostic factors.
  
  
  METHODS
  Data are from 1209 depressive and/or anxiety patients residing in primary and specialized care settings, participating in the Netherlands Study of Depression and Anxiety. Diagnostic and Life Chart Interviews provided 2-year course information.
  
  
  RESULTS
  Course was more favorable for pure depression (n=267, median episode duration = 6 months, 24.5% chronic) than for pure anxiety (n=487, median duration = 16 months, 41.9% chronic). Worst course was observed in the comorbid depression-anxiety group (n=455, median duration > 24 months, 56.8% chronic). Independent predictors of poor diagnostic and symptom trajectory outcomes were severity and duration of index episode, comorbid depression-anxiety, earlier onset age and older age. With only these factors a reasonable discriminative ability (C-statistic 0.72-0.77) was reached in predicting 2-year prognosis.
  
  
  CONCLUSIONS
  Depression and anxiety cases concern prevalent - not incident - cases. This, however, reflects the actual patient population in primary and specialized care settings.
  
  
  CONCLUSIONS
  Their differential course trajectory justifies separate consideration of pure depression, pure anxiety and comorbid anxiety-depression in clinical practice and psychiatric nosology.
authors.affiliation: Department of Psychiatry/EMGO Institute for Health and Care Research/Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands. b.penninx@vumc.nl
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.forename: Willem A
authors.initials: WA
authors.lastname: Nolen
authors.forename: Femke
authors.initials: F
authors.lastname: Lamers
authors.forename: Frans G
authors.initials: FG
authors.lastname: Zitman
authors.forename: Johannes H
authors.initials: JH
authors.lastname: Smit
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.forename: Peter J
authors.initials: PJ
authors.lastname: de Jong
authors.forename: Harm W J
authors.initials: HW
authors.lastname: van Marwijk
authors.forename: Klaas
authors.initials: K
authors.lastname: van der Meer
authors.forename: Peter
authors.initials: P
authors.lastname: Verhaak
authors.forename: Miranda G H
authors.initials: MG
authors.lastname: Laurant
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.forename: Witte J
authors.initials: WJ
authors.lastname: Hoogendijk
authors.forename: Nic
authors.initials: N
authors.lastname: van der Wee
authors.forename: Johan
authors.initials: J
authors.lastname: Ormel
authors.forename: Richard
authors.initials: R
authors.lastname: van Dyck
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D009426:Netherlands; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires