Anxiety symptom severity and functional recovery or relapse.
Anxiety symptom severity and functional recovery or relapse.
Background:
Anxiety disorders are associated with significant disability. There is growing interest in the question of whether pharmacotherapy that effectively reduces symptoms can also restore function. Recovery could potentially be defined as a lack of disability, with an associated reduction in symptom severity. Conversely, relapse could potentially be defined in terms of either increased disability or increased symptoms.
Methods:
We analyzed a database of randomized controlled trials of escitalopram in generalized anxiety disorder (GAD) and social anxiety disorder (SAD), focusing on the relationship between disorder-specific severity scales, and the Sheehan Disability Scale (SDS). In short-term studies, cut-points on symptom scales were derived for recovered function. In relapse prevention studies, the effects of defining relapse in terms of increased disability scores were examined.
Results:
In GAD and SAD, there is a close correlation between primary symptom severity scales and the SDS, both in the short term and during relapse prevention. Thus, functional recovery is associated with relatively low symptom severity scores, and rates of relapse—defined in terms of increased disability—are significantly lower on escitalopram than on placebo.
Conclusions:
These data indicate that recovery and relapse can potentially be defined either in terms of symptom severity or functioning. Thus, the concept of functional recovery and relapse may be useful in defining treatment outcomes. Longer-term treatment of anxiety disorders is needed to ensure functional recovery.
81-88
Stein, D.J.
908f8238-f5e4-4ea1-9f19-9be45feea5b6
Bandelow, B.
f90459a9-1f40-40bb-bd92-d4c1e4cbb9f4
Dolberg, O.T.
a3e324dd-5ade-49d6-99f4-00ef6ad78542
Andersen, H.F.
23022aa3-3faf-4e24-848a-526652a6c893
Baldwin, D.S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
April 2009
Stein, D.J.
908f8238-f5e4-4ea1-9f19-9be45feea5b6
Bandelow, B.
f90459a9-1f40-40bb-bd92-d4c1e4cbb9f4
Dolberg, O.T.
a3e324dd-5ade-49d6-99f4-00ef6ad78542
Andersen, H.F.
23022aa3-3faf-4e24-848a-526652a6c893
Baldwin, D.S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Stein, D.J., Bandelow, B., Dolberg, O.T., Andersen, H.F. and Baldwin, D.S.
(2009)
Anxiety symptom severity and functional recovery or relapse.
Annals of Clinical Psychiatry, 21 (2), .
Abstract
Background:
Anxiety disorders are associated with significant disability. There is growing interest in the question of whether pharmacotherapy that effectively reduces symptoms can also restore function. Recovery could potentially be defined as a lack of disability, with an associated reduction in symptom severity. Conversely, relapse could potentially be defined in terms of either increased disability or increased symptoms.
Methods:
We analyzed a database of randomized controlled trials of escitalopram in generalized anxiety disorder (GAD) and social anxiety disorder (SAD), focusing on the relationship between disorder-specific severity scales, and the Sheehan Disability Scale (SDS). In short-term studies, cut-points on symptom scales were derived for recovered function. In relapse prevention studies, the effects of defining relapse in terms of increased disability scores were examined.
Results:
In GAD and SAD, there is a close correlation between primary symptom severity scales and the SDS, both in the short term and during relapse prevention. Thus, functional recovery is associated with relatively low symptom severity scores, and rates of relapse—defined in terms of increased disability—are significantly lower on escitalopram than on placebo.
Conclusions:
These data indicate that recovery and relapse can potentially be defined either in terms of symptom severity or functioning. Thus, the concept of functional recovery and relapse may be useful in defining treatment outcomes. Longer-term treatment of anxiety disorders is needed to ensure functional recovery.
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Published date: April 2009
Identifiers
Local EPrints ID: 148055
URI: http://eprints.soton.ac.uk/id/eprint/148055
ISSN: 1040-1237
PURE UUID: 8eee5a21-d919-4587-8b0c-d448068158fd
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Date deposited: 27 Apr 2010 10:17
Last modified: 09 Jan 2022 02:48
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Contributors
Author:
D.J. Stein
Author:
B. Bandelow
Author:
O.T. Dolberg
Author:
H.F. Andersen
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