Predictors of outcome in outpatients with anxiety disorders: the Leiden routine outcome monitoring study.
Little is known about the predictors of outcome in anxiety disorders in naturalistic outpatient settings. We analyzed 2-year follow-up data collected through Routine Outcome Monitoring (ROM) in a naturalistic sample of 917 outpatients in psychiatric specialty care in order to identify factors predicting outcome. We included patients with panic disorder with or without agoraphobia, agoraphobia without panic, social phobia, or generalized anxiety disorder. Main findings from Cox regression analyses demonstrated that several socio-demographic variables (having a non-Dutch ethnicity [HR = 0.71)], not having a daily occupation [HR = 0.76]) and clinical factors (having a diagnosis of agoraphobia [HR = 0.67], high affective lability [HR = 0.80] and behavior problems [HR = 0.84]) decreased chances of response (defined as 50% reduction of anxiety severity) over the period of two years. Living with family had a protective predictive value [HR = 1.41]. These results may imply that factors that could be thought to limit societal participation, are associated with elevated risk of poor outcome. A comprehensive ROM screening process at intake may aid clinicians in the identification of patients at risk of chronicity.
Leiden University Medical Centre, Department of Psychiatry, P.O. Box 7500, 2300 RC Leiden, The Netherlands. Electronic address: a.schat@lumc.nl.
A
A
Schat
M S
MS
van Noorden
M J
MJ
Noom
E J
EJ
Giltay
N J A
NJ
van der Wee
R R J M
RR
Vermeiren
F G
FG
Zitman
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D017063:Outcome Assessment, Health Care; D010045:Outpatients / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D055815:Young Adult
Anxiety disorders; Epidemiology; Naturalistic; Outpatients; Prospective cohort study