Prevalence and clinical characteristics of remission during treatment in generalized anxiety

Abstract

Objective. Although the remission criteria for generalized anxiety are well defined, there is not much data available on the point prevalence of remission. The Measuring Impact of Remission in Anxiety Disorders in Belgium (MIRABEL) study is a naturalistic study designed to document the point prevalence of remission in patients treated for general anxiety and potential factors affecting this prevalence. Methods. The study population consisted of 618 adult outpatients being treated for generalized anxiety. The sample is defined by the key symptoms of generalized anxiety disorder rather than by fulfilling the exact DSM-IV-TR diagnostic criteria. Remission was defined as a Hamilton Anxiety Scale (HAM-A) score of less than or equal to 7. To reduce the interrater reliability, the HAM-A was assessed by the attending physicians who had no specific training. Factors investigated as possibly related to remission included sociodemographic, disease and treatment characteristics. Results. The point prevalence of remission in the study population was estimated at 13.3%. Remission prevalence varied with occupational status and severity of the current anxiety episode. Remission prevalence was lower in the presence of comorbidity and was proportional to the number of comorbid symptoms. Remitters took fewer medications but were treated longer. Remission prevalence was higher in patients who were taking antidepressants, but was lower in patients who were taking sedatives. Conclusions. These findings underline the poor prognosis of generalized anxiety.

Key words::

• Generalized anxiety
• remission
• prevalence
• remission-related factors
• remission-inhibiting factors

Acknowledgements

The authors would like to thank all the participants for their cooperation, and Anne Morsel for her linguistic advice.

Statement of interest

Annick Mignon and Patricia Slachmuylders were full-time employees of Wyeth pharmaceuticals at the time of the development and implementation of the study. There are no conflicts of interest to be reported for any of the other authors. Wyeth pharmaceuticals was only associated with the elaboration of the protocol and the collection of the data and was not involved in the analysis and interpretation of data.

The study was partly supported by a grant from Wyeth Belgium and by a Research Fund of the University of Antwerp.