title: Prediction of 6-yr symptom course trajectories of anxiety disorders by diagnostic, clinical and psychological variables.
abstract: This study aimed to identify course trajectories of anxiety disorder using a data-driven method and to determine the incremental predictive value of clinical and psychological variables over and above diagnostic categories. 703 patients with DSM-IV panic disorder with or without agoraphobia, agoraphobia, social phobia, or generalized anxiety disorder were selected from a prospective cohort study. Latent Growth Mixture Modeling was conducted, based on symptoms of anxiety and avoidance as assessed with the Life Chart Interview covering a 6-year time period. In 44% of the participants symptoms of anxiety and avoidance improved, in 24% remained stable, in 25% slightly increased, and in 7% severely increased. Identified course trajectories were predicted by baseline DSM-IV anxiety categories, clinical variables (i.e., severity and duration and level of disability) and psychological predictors (i.e., neuroticism, extraversion, anxiety sensitivity, worry, and rumination). Clinical variables better predicted unfavorable course trajectories than psychological predictors, over and above diagnostic categories.
authors.affiliation: Institute of Psychology, Leiden University and Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: spinhoven@fsw.leidenuniv.nl.
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.affiliation: Department of Psychiatry/EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: n.batelaan@ggzingeest.nl.
authors.forename: Neeltje
authors.initials: N
authors.lastname: Batelaan
authors.affiliation: Department of Psychiatry/EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: d.rhebergen@ggzingeest.nl.
authors.forename: Didi
authors.initials: D
authors.lastname: Rhebergen
authors.affiliation: Department of Psychiatry/EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: t.balkom@ggzingeest.nl.
authors.forename: Anton
authors.initials: A
authors.lastname: van Balkom
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: r.a.schoevers@umcg.nl.
authors.forename: Robert
authors.initials: R
authors.lastname: Schoevers
authors.affiliation: Department of Psychiatry/EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: b.penninx@ggzingeest.nl.
authors.forename: Brenda W
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D011446:Prospective Studies
keywords: Anxiety; Anxiety disorder; Anxiety sensitivity; Avoidance; Disability; Personality traits; Rumination; Symptom course trajectories; Worry