title: Effects of anxiety on the long-term course of depressive disorders.
abstract: BACKGROUND
  It is well established that the presence of prominent anxiety within depressive episodes portends poorer outcomes. Important questions remain as to which anxiety features are important to outcome and how sustained their prognostic effects are over time.
  
  
  OBJECTIVE
  To examine the relative prognostic importance of specific anxiety features and to determine whether their effects persist over decades and apply to both unipolar and bipolar conditions.
  
  
  METHODS
  Participants with unipolar (n = 476) or bipolar (n = 335) depressive disorders were intensively followed for a mean of 16.7 years (s.d. = 8.5).
  
  
  RESULTS
  The number and severity of anxiety symptoms, but not the presence of pre-existing anxiety disorders, showed a robust and continuous relationship to the subsequent time spent in depressive episodes in both unipolar and bipolar depressive disorder. The strength of this relationship changed little over five successive 5-year periods.
  
  
  CONCLUSIONS
  The severity of current anxiety symptoms within depressive episodes correlates strongly with the persistence of subsequent depressive symptoms and this relationship is stable over decades.
authors: Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins, Iowa City, IA 52242, USA. william-coryell@uiowa.edu
authors: William
authors: W
authors: Coryell
authors: Jess G
authors: JG
authors: Fiedorowicz
authors: David
authors: D
authors: Solomon
authors: Andrew C
authors: AC
authors: Leon
authors: John P
authors: JP
authors: Rice
authors: Martin B
authors: MB
authors: Keller
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult