title: Predictors of relapse in a study of duloxetine treatment for patients  with generalized anxiety disorder.
abstract: OBJECTIVE
  Data from a relapse prevention study of duloxetine treatment for adults with generalized anxiety disorder (GAD) were examined to identify predictors of relapse.
  
  
  METHODS
  Patients responding to 6 months of open-label duloxetine treatment were randomized to continuation with duloxetine or withdrawal to placebo for a 6-month double-blind continuation phase (duloxetine, N= 216; placebo, N= 213). Post hoc analyses compared time to GAD relapse during continuation phase by using predictor variables that included patient demographics, symptom severity measures (Hamilton Anxiety Scale Scores [HAMA], Hospital Anxiety and Depression Scale), functional outcomes, and visual analogue scale (VAS) pain measures. Univariate and multivariate analyses were performed using predictor variables from time of randomization into the continuation, withdrawal phase.
  
  
  RESULTS
  Severity of anxiety symptoms, degree of functional impairment, and severity of pain at time of randomization were significantly predictive of likelihood of relapse during the continuation phase. Multivariate backwards elimination analysis of significant univariate predictors identified HAMA item one (anxious mood) ≥ 1 and severity of pain while awake (≥ 30 on VAS) as the strongest predictors of GAD relapse.
  
  
  CONCLUSIONS
  For patients with GAD responding to open-label treatment with duloxetine, residual symptoms related to anxious mood, pain severity, and psychosocial function were associated with increased relapse risk, although the greatest risk was associated with anxious mood and increased severity of pain while awake.
authors.affiliation: Clinical Psychopharmacology Research Program, McLean Hospital, Belmont, Massachusetts 02478, USA. abodkin@mclean.harvard.edu
authors.forename: J Alexander
authors.initials: JA
authors.lastname: Bodkin
authors.forename: Christer
authors.initials: C
authors.lastname: Allgulander
authors.forename: Pierre M
authors.initials: PM
authors.lastname: Llorca
authors.forename: Melissa E
authors.initials: ME
authors.lastname: Spann
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Walker
authors.forename: James M
authors.initials: JM
authors.lastname: Russell
authors.forename: Susan G
authors.initials: SG
authors.lastname: Ball
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D000068736:Duloxetine Hydrochloride; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D055502:Secondary Prevention; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013876:Thiophenes; D000068736:Duloxetine Hydrochloride