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Anxiety in middle adulthood: effects of age and time on the 14-year course of panic disorder, social phobia and generalized anxiety disorder

Published online by Cambridge University Press:  30 July 2008

H. J. Ramsawh ,
S. D. Raffa ,
M. Orlando Edelen ,
R. Rende  and
M. B. Keller
H. J. Ramsawh*
Affiliation:
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
S. D. Raffa
Affiliation:
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
M. Orlando Edelen
Affiliation:
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
R. Rende
Affiliation:
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
M. B. Keller
Affiliation:
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
*
*Address for correspondence: H. J. Ramsawh, Ph.D., University of California, San Diego, 8939 Villa La Jolla Drive, Suite 200, La Jolla, CA 92037, USA. (Email: hramsawh@ucsd.edu)
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Abstract

Background

Much about the long-term course of anxiety disorders is unknown. The present study utilizes a naturalistic, longitudinal, short-interval follow-up design to elucidate the course of anxiety disorders over 14 years in a largely middle-aged adult sample recruited from out-patient psychiatry and primary care facilities.

Method

The sample consisted of 453 participants with a diagnosis of panic disorder (PD), social phobia (SP) and/or generalized anxiety disorder (GAD). Anxiety symptom ratings were tracked using weekly psychiatric status ratings (PSRs). Controlling for demographic and clinical variables, the course of PD, GAD and SP were examined using longitudinal growth models, with the most severe PSR at each follow-up point as the main outcome variable.

Results

PSRs significantly decreased in severity over time in each of the three disorders. In the interaction effects models, age×time had a significant effect on course for PD and GAD, but not for SP, in that older age was associated with lower PSRs over time.

Conclusions

The present findings suggest that the severity of anxiety disorders declines over time, although this decline is modest and depends on the specific disorder being assessed. Older individuals with PD and GAD have a better prognosis than their younger counterparts, as their course is characterized by a steeper decline in severity. The present findings provide important information about the course of anxiety disorders in mid-life.

Keywords

Anxiety disorderslongitudinal studiespanic disorderphobic disordersprospective studies
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 4 , April 2009 , pp. 615 - 624
Copyright
Copyright © 2008 Cambridge University Press

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