Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-19T06:50:43.958Z Has data issue: false hasContentIssue false
  • English
  • Français

Systematic review of the outcome of anxiety and depressive disorders

Published online by Cambridge University Press:  06 August 2018

J. Emmanuel ,
S. Simmonds  and
P. Tyrer
Get access Rights & Permissions [Opens in a new window]

Abstract

Background Although there have been many changes in the diagnosis of anxiety and depressive disorders in the past 20 years there have been few comparative enquiries into the clinical outcome of greater diagnostic categories. We therefore compared the outcome of all studies which compared the outcome of specific anxiety and depressive disorders using the standard procedures of systematic review.

Method A Medline search was carried out of all studies comparing the outcome of anxiety and depressive disorders or mixed anxiety-depressive disorders in which information was available separately for each disorder.

Results Eight studies satisfied the search criteria (all involving a period of observation of two years or greater); only one of these included randomisation of treatment and comparison between specific anxiety disorder outcome. There was a somewhat better outcome in patients with depressive disorders compared with anxiety ones, and strong evidence that both anxiety and depressive disorders singly had better outcomes than comorbid mixed disorders.

Conclusion Comorbid anxiety-depressive disorders have a poor outcome compared with single anxiety and depressive disorders, and there is some evidence that anxiety disorders have a worse outcome than depressive ones.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 173 , Issue S34: Recognition and management of anxiey syndromes , July 1998 , pp. 35 - 41
Copyright
Copyright © The Royal College of Psychiatrists, 1998 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akiskal, H. S. (1983) Dysthymic disorder: psychopathology of proposed chronic depressive subtypes. American Journal of Psychiatry. 140, 11–20.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Andrews, G., Stewart, G., Morrise-Yates, A., et al (1990) Evidence for a general neurotic syndrome. British Journal of Psychiatry, 157, 6–12.Google Scholar
Brown, C. & Schulberg, H. C. (1995) The efficacy of psychosocial treatments in primary care: a review of randomised clinical trials. General Hospital Psychiatry, 17, 414–424.CrossRefGoogle Scholar
Brown, T. A., Antony, M. A. & Barlow, D. H. (1995) Diagnostic comorbidity in panic disorder: effect on treatment outcome and course of comorbid diagnoses following treatment. Journal of Consulting and Clinical Psychology, 63, 404–418.Google Scholar
Delini-Stula, A., Mikkelsen, H. & Angst, J. (1995) Therapeutic efficacy of antidepressants in agitated anxious depression – a meta-analysis of moclobemide studies. Journal of Affective Disorders, 35, 21–30.CrossRefGoogle ScholarPubMed
Geddes, J. R. & Harrison, P. J. (1997) Closing the gap between research and practice. British Journal of Psychiatry, 171, 220–225.CrossRefGoogle Scholar
Johnstone, E. C., Cunningham Owens, D. G., Frith, C. D., et al (1980) Neurotic illness and its response to anxiolytic and antidepressant therapy. Psychological Medicine, 10, 321–328.Google Scholar
Kendell, R. E. (1974) The stability of psychiatric diagnoses. British Journal of Psychiatry, 124, 352–356.CrossRefGoogle Scholar
Kendell, R. E. (1989) Clinical validity. Psychological Medicine, 19, 45–55.Google Scholar
Lesser, M. D., Rubin, R. T., Pecknold, J. C., et al (1988) Secondary depression in panic disorder and agoraphobia. Archives of General Psychiatry, 45, 437–443.Google Scholar
Murphy, J. M., Olivier, D. C., Sobol, A. M., et al (1986) Diagnosis and outcome; depression and anxiety in a general population. Psychological Medicine, 16, 117–126.Google Scholar
Noyes, R., Reich, J., Christiansen, J., et al (1980) Outcome of panic disorder: relationship to diagnostic subtypes and comorbidity. Archives of General Psychiatry, 47, 809–818.Google Scholar
Ormel, J., Oldehinkel, T., Brilman, E., et al (1993) Outcome of depression and anxiety in primary care. A three wave 3^ year study of psychopathology and disability. Archives of General Psychiatry, 50, 759–757.Google Scholar
Puccinelli, M. & Wilkinson, G. (1994) Outcome of depression in psychiatric settings. British Journal of Psychiatry, 164, 297–304.Google Scholar
Quinton, D., Gulliver, L. & Rutter, M. (1995) A 15–20 year follow-up of adult psychiatric patients. psychiatric disorder and social functioning. British Journal of Psychiatry, 167, 315–323.Google Scholar
Reich, J. H. & Vasile, R. G. (1993) Effect of personality disorders on the treatment outcome of axis I conditions: an update. Journal of Nervous and Mental Disease, 181, 475–484.Google Scholar
Roth, M. & Argyle, N. (1988) Anxiety, panic and phobic disorders: An overview. Journal of Psychiatric Research, 22 (suppl. 1), 33–54.Google Scholar
Sackett, D. L., Rosenberg, W. M., Grey, J. A., et al (1996) Evidence based medicine: What is it and what it isn't. British Medical Journal, 31, 71–72.Google Scholar
Schapira, K., Roth, M., Kerr, T. A., et al (1972) The prognosis of affective disorders: the differentiation of anxiety states from depressive illnesses. British Journal of Psychiatry, 121, 175–181.Google Scholar
Shea, M. T., Pilkonis, P. A., Beckham, E., et al (1990) Personality disorders and treatment outcome in the NIMH Treatment of Depression Collaborative Research Program. American Journal of Psychiatry, 147, 711–718.Google Scholar
Surtees, P. G. & Barkley, C. (1994) Future imperfect: the longterm outcome of depressive disorder. British Journal of Psychiatry, 164, 327–341.Google Scholar
Tyrer, P. (1985) Neurosis divisible? Lancet, i, 685–688.CrossRefGoogle Scholar
Tyrer, P., Sievewright, N., Ferguson, B., et al (1992) The general neurotic syndrome: a coaxial diagnosis of anxiety, depression and personality disorder. Acta Psychiatrica Scandinavica, 85, 201–206.Google Scholar
Tyrer, P., Sievewright, N., Ferguson, B., et al (1993) The Nottingham study of neurotic disorder. Effect of personality status on response to drug treatment, cognitive therapy and self help over three years. British Journal of Psychiatry, 162, 219–226.Google Scholar
Van Valkenberg, C., Akiskal, H. S., Puzantian, V., et al (1984) Anxious depressions. Clinical, family history and naturalistic outcome – comparisons with panic and major depressive disorders. Journal of Affective Disorders, 6, 67–82.Google Scholar
Vollrath, M. & Angst, J. (1989) Outcome of panic and depression in a seven year follow-up: results of the Zurich study. Acta Psychiatrica Scandinavica, 80, 591–596.Google Scholar
Wittchen, H. U., Essau, C. A. & Krieg, J. C. (1991) Anxiety disorders: similarities and differences of comorbidity in treated and untreated groups. British Journal of Psychiatry, 159 (suppl. 12), 23–33.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.