Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.
Psychol Med. 2023 Mar;53(4):1334-1342. doi: 10.1017/S0033291721002877. Epub 2021 Jul 23.
Anxiety disorders frequently recur in clinical populations, but the risk of recurrence of anxiety disorders is largely unknown in the general population. In this study, recurrence of anxiety and its predictors were studied in a large cohort of the adult general population.
Baseline, 3-year and 6-year follow-up data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). Respondents ( = 468) who had been in remission for at least a year prior to baseline were included. Recurrence was assessed at 3 and 6 years after baseline, using the Composite International Diagnostic Interview version 3.0. Cumulative recurrence rates were estimated using the number of years since remission of the last anxiety disorder. Furthermore, Cox regression analyses were conducted to investigate predictors of recurrence, using a broad range of putative predictors.
The estimated cumulative recurrence rate was 2.1% at 1 year, 6.6% at 5 years, 10.6% at 10 years, and 16.2% at 20 years. Univariate regression analyses predicted a shorter time to recurrence for several variables, of which younger age at interview, parental psychopathology, neuroticism and a current depressive disorder remained significant in the, age and gender-adjusted, multivariable regression analysis.
Recurrence of anxiety disorders in the general population is common and the risk of recurrence extends over a lengthy period of time. In clinical practice, alertness to recurrence, monitoring of symptoms, and quick access to health care in case of recurrence are needed.
焦虑障碍在临床人群中经常复发,但在普通人群中,焦虑障碍的复发风险很大程度上是未知的。在这项研究中,研究了一个大型普通人群队列中焦虑症的复发及其预测因素。
基线、3 年和 6 年随访数据来自荷兰心理健康调查和发病率研究-2(NEMESIS-2)。将基线前至少一年缓解的受访者(=468)纳入研究。使用复合国际诊断访谈版 3.0 在基线后 3 年和 6 年评估复发。使用从最后一次焦虑障碍缓解以来的年数来估计累积复发率。此外,使用广泛的潜在预测因子进行 Cox 回归分析,以调查复发的预测因子。
估计的累积复发率为 1 年时为 2.1%,5 年时为 6.6%,10 年时为 10.6%,20 年时为 16.2%。单变量回归分析预测了几个变量的复发时间更短,其中访谈时年龄较小、父母精神病史、神经质和当前抑郁障碍在年龄和性别调整后的多变量回归分析中仍然显著。
普通人群中焦虑障碍的复发很常见,复发风险持续很长时间。在临床实践中,需要警惕复发、监测症状,并在复发时快速获得医疗保健。