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Multicenter Study
. 2011 May;41(5):1019-28.
doi: 10.1017/S0033291710001777. Epub 2010 Sep 14.

The association of personality disorders with the prospective 7-year course of anxiety disorders

E B Ansell  1 , A Pinto, M O Edelen, J C Markowitz, C A Sanislow, S Yen, M Zanarini, A E Skodol, M T Shea, L C Morey, J G Gunderson, T H McGlashan, C M Grilo
Affiliations
Multicenter Study

The association of personality disorders with the prospective 7-year course of anxiety disorders

E B Ansell et al. Psychol Med. 2011 May.

Abstract

Background: This study prospectively examined the natural clinical course of six anxiety disorders over 7 years of follow-up in individuals with personality disorders (PDs) and/or major depressive disorder. Rates of remission, relapse, new episode onset and chronicity of anxiety disorders were examined for specific associations with PDs.

Method: Participants were 499 patients with anxiety disorders in the Collaborative Longitudinal Personality Disorders Study, who were assessed with structured interviews for psychiatric disorders at yearly intervals throughout 7 years of follow-up. These data were used to determine probabilities of changes in disorder status for social phobia (SP), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder and panic disorder with agoraphobia.

Results: Estimated remission rates for anxiety disorders in this study group ranged from 73% to 94%. For those patients who remitted from an anxiety disorder, relapse rates ranged from 34% to 67%. Rates for new episode onsets of anxiety disorders ranged from 3% to 17%. Specific PDs demonstrated associations with remission, relapse, new episode onsets and chronicity of anxiety disorders. Associations were identified between schizotypal PD with course of SP, PTSD and GAD; avoidant PD with course of SP and OCD; obsessive-compulsive PD with course of GAD, OCD, and agoraphobia; and borderline PD with course of OCD, GAD and panic with agoraphobia.

Conclusions: Findings suggest that specific PD diagnoses have negative prognostic significance for the course of anxiety disorders underscoring the importance of assessing and considering PD diagnoses in patients with anxiety disorders.

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Figures

Fig. 1
Fig. 1
Remission survival curves for anxiety disorders over 7 years (364 weeks) of follow-up. GAD, generalized anxiety disorder; OCD, obsessive-compulsive disorder; PTSD, post-traumatic stress disorder; agor, agoraphobia.
Fig. 2
Fig. 2
Relapse survival curves for anxiety disorders over 7 years (364 weeks) of follow-up. GAD, generalized anxiety disorder; OCD, obsessive-compulsive disorder; PTSD, post-traumatic stress disorder; agor, agoraphobia.
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