PHENOMENOLOGY AND COURSE OF GENERALIZED ANXIETY DISORDER

Background. The diagnostic category of generalised anxiety disorder (G AD) was originally intended to describe residual anxiety states. Over the years clinical criteria have been refined in an attempt to describ e a unique diagnostic entity. Given these changes, little is known abo ut the clinical course of this newly defined disorder. This study inve stigates the longitudinal course, including remission and relapse rate s, for patients with DSM-III-R defined GAD. Method. Analysis of the 16 4-patients with GAD participating in the Harvard Anxiety Research Prog ram. Patients were assessed with a structured clinical interview at in take and re-examined at six month intervals for two years and then ann ually for one to two years. Psychiatric Status Ratings were assigned a t each interview point. Kaplan-Meier curves were constructed to assess likelihood of remission. Results. Comorbidity was high, with panic di sorder and social phobia as the most frequently found comorbid disorde rs. The likelihood of remission was 0.15 after one year and 0.25 after two years. The probability of becoming asymptomatic from all psychiat ric symptoms was only 0.08. Conclusions. This prospective study confir ms the chronicity associated with GAD and extends this finding to defi ne the one and two year remission rates for the disorder. Likelihood o f remission for GAD and any other comorbid condition after one year wa s half the annual remission rate for GAD alone.