title: Long-term disability in anxiety disorders.
abstract: This longitudinal study aims to investigate differences in long-term disability between social anxiety disorder (SAD), panic disorder with agoraphobia (PDA), panic disorder without agoraphobia (PD), generalized anxiety disorder (GAD) and multiple anxiety disorders (multiple AD), focusing on the effects of different course trajectories (remission, recurrence and chronic course) and specific symptom dimensions (anxiety arousal and avoidance behaviour).
  
  
  
  Data were used from participants with no psychiatric diagnosis (healthy controls, n = 647) or with a current anxiety disorder (SAD, n = 191; PDA, n = 90; PD, n = 84; GAD, n = 110; multiple AD, n = 480). Severity of anxiety arousal and avoidance behaviour symptoms was measured using the Beck Anxiety Inventory and the Fear Questionnaire. The World Health Organization Disability Assessment Schedule II was used to measure disability.
  
  
  
  Long-term disability was most prevalent in participants with SAD and multiple AD, and lowest in PDA and PD. GAD had an intermediate position. Anxiety arousal and avoidance behaviour were associated with more long-term disability in anxiety disorders than course trajectories.
  
  
  
  Various anxiety disorders have different disability levels over 4 years of time, therefore diagnostic distinction is important for treatment focus. Anxiety arousal and avoidance behaviour are major predictors for long-term disability in anxiety disorders.
authors.affiliation: Department of Psychiatry, Pro Persona Mental Health Care, Zandstraat 54, Veenendaal, 3905 ED, The Netherlands. s.hendriks@propersona.nl.
authors.forename: Sanne M
authors.initials: SM
authors.lastname: Hendriks
authors.affiliation: Pro Persona Mental Health Care, Radboud University Nijmegen, Reinier Postlaan 6, Nijmegen, 6525 GC, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Spijker
authors.affiliation: Department of Psychiatry/EMGO Institute, VU University Medical Center, AJ Ernststraat 887, Amsterdam, 1081 HL, The Netherlands.
authors.forename: Carmilla M M
authors.initials: CM
authors.lastname: Licht
authors.affiliation: Pro Persona Mental Health Care, Willy Brandtlaan 20, Ede, 6717 RR, The Netherlands.
authors.forename: Florian
authors.initials: F
authors.lastname: Hardeveld
authors.affiliation: Netherlands Institute of Mental Health and Addiction, Da Costakade 45, Utrecht, 3521 VS, The Netherlands.
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.affiliation: Department of Psychiatry/EMGO Institute, VU University Medical Center, AJ Ernststraat 887, Amsterdam, 1081 HL, The Netherlands.
authors.forename: Neeltje M
authors.initials: NM
authors.lastname: Batelaan
authors.affiliation: Department of Psychiatry/EMGO Institute, VU University Medical Center, AJ Ernststraat 887, Amsterdam, 1081 HL, The Netherlands.
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.affiliation: Department of Psychiatry/EMGO Institute, VU University Medical Center, AJ Ernststraat 887, Amsterdam, 1081 HL, The Netherlands.
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000379:Agoraphobia / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D001143:Arousal; D001362:Avoidance Learning; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D010698:Phobic Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D011379:Prognosis; D012008:Recurrence; D011795:Surveys and Questionnaires; D055815:Young Adult