Diagnostic instability of recurrence and the impact on recurrence rates in depressive and anxiety disorders

Scholten, Willemijn; Batelaan, Neeltje M.; Penninx, Brenda W. J. H.; Balkom, A.J.L.M. van; Smit, Johannes H.; Schoevers, Robert A.; Oppen, Patricia van

doi:10.1016/j.jad.2016.02.025

Cited by 64 publications

(65 citation statements)

References 33 publications

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“…The Netherlands Study of Depression and Anxiety (NESDA) contrasts sharply with most clinical studies by the large number of patients it included . Based on NESDA, among those with remitted depression, recurrence rates varied depending on the length of follow‐up (from 22% over 2 year to 38% over 4 year ) and patient group selected (e.g. from 34% among mental healthcare users to 22% among all respondents with current MDD ).…”

Section: Introductionmentioning

confidence: 99%

Recurrence and chronicity of major depressive disorder and their risk indicators in a population cohort

Have

Graaf

Dorsselaer

et al. 2018

Acta Psychiatr Scand

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Section: Introductionmentioning

confidence: 99%

Recurrence and chronicity of major depressive disorder and their risk indicators in a population cohort

Have

Graaf

Dorsselaer

et al. 2018

Acta Psychiatr Scand

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“…Because of comorbidity (Kessler et al., , Lamers et al., ), diagnostic instability within affective disorders (Hovenkamp‐Hermelink et al., ; Scholten et al., ) and low statistical power when analyzing small subgroups, we decided to group the new onsets of disorders together in our main analysis. However, since a breakdown of this group into the onset of specific disorders might still be informative, we provide the numbers and explorative post‐hoc analyses here.…”

Section: Resultsmentioning

confidence: 99%

“…Limitations include the compilation of participants with different anxiety disorders into one group. This was necessary because, partly due to high comorbidity across anxiety disorders (Lamers et al., ; Scholten et al., ), there were not enough patients per single anxiety disorder diagnosis (e.g., pure GAD) to allow for separate analyses. Also, the study sample used in the onset analyses is over‐inclusive of participants with a remitted diagnosis, which can hamper generalizability of the study results to the general population.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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The predictive value of Approach and Avoidance tendencies on the onset and course of depression and anxiety disorders

et al. 2018

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BackgroundTrait and automatic approach‐avoidance (AA) tendencies are central concepts in research on affective disorders. We longitudinally examined the associations of trait and automatic AA tendencies with the risk of onset and chronicity of anxiety and depressive disorders.MethodsParticipants were subdivided into those with (n = 766) versus without (n = 1,636) a current anxiety or depression diagnosis at baseline. Clinical diagnoses were reassessed after 2‐year follow‐up. Automatic AA tendencies in reaction to facial expressions were assessed using the Approach‐Avoidance Task, whereas self‐reported trait AA tendencies were assessed using the Behavioral Inhibition System and the Behavioral Activation System scales. Analyses were adjusted for socio‐demographics (basic adjustment) and for severity and history of psychopathology (full adjustment).ResultsStronger trait avoidance tendencies predicted both increased risk of onset and increased risk of a chronic course of anxiety disorders after full adjustment (Odds ratioonset = 1.55, P < .001, and Odds ratiochronicity = 1.31, P = .03). The associations between stronger trait avoidance tendencies and increased risk of onset and chronicity of depressive disorders were no longer significant after full adjustment. In contrast, trait approach tendencies and automatic AA tendencies were not related to onset or chronicity of disorders.ConclusionsIncreased trait avoidance tendencies are a risk factor for affective disorders in general, with possibly a slightly more pronounced role in anxiety than depressive disorders. This underlines the importance of addressing trait avoidance tendencies in both the treatment and aftercare of affective disorders.

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“…Dutch researchers documented that recurrence rates are higher if we look beyond the artificial confines of DSM-V diagnoses. When they limited their measurements only to the recurrence of anxiety disorders with the same diagnosis, recurrence rates were approximately 24% overall, but when other anxiety disorders were included, the recurrence rate was approximately 55% (Scholten et al, 2016). When life stress is more severe, the symptoms of anxiety proliferate and the anxiety disorder intensifies.…”

Section: Introductionmentioning

confidence: 99%

The House Is Crashing down on Me: Integrating Mindfulness, Breath Training, and Heart Rate Variability Biofeedback for an Anxiety Disorder in a 71-Year-Old Caregiver

Moss

2016

Biofeedback

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Caregiver stress is a growing problem with an aging population, and many spouses are cast in the caregiver role for extended periods. Preexisting anxiety disorders commonly recur in the face of caregiver stress. This article narrates the case of a 71-year-old retired professional woman serving as caregiver for a husband with dementia. The stress of the caregiver role served to trigger a recurrence of a previously treated anxiety disorder. The case narrative illustrates the value of mindfulness, breath training, and heart rate variability biofeedback for the anxiety disorder, as well as an effort to instill sustainable self-regulation skills and lifestyle changes for greater resilience in this long-term situation. Some of the lifestyle-oriented interventions are summarized only briefly in this article.

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Diagnostic instability of recurrence and the impact on recurrence rates in depressive and anxiety disorders

Cited by 64 publications

References 33 publications

Recurrence and chronicity of major depressive disorder and their risk indicators in a population cohort

Recurrence and chronicity of major depressive disorder and their risk indicators in a population cohort

The predictive value of Approach and Avoidance tendencies on the onset and course of depression and anxiety disorders

The House Is Crashing down on Me: Integrating Mindfulness, Breath Training, and Heart Rate Variability Biofeedback for an Anxiety Disorder in a 71-Year-Old Caregiver

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