The association of personality disorders with the prospective 7-year course of anxiety disorders

E. B. Ansell, Anthony Pinto, M. O. Edelen, J. C. Markowitz, C. A. Sanislow, S. Yen, M. Zanarini, A. E. Skodol, M. T. Shea, L. C. Morey, J. G. Gunderson, T. H. McGlashan, C. M. Grilo

Research output: Contribution to journalArticle

Abstract

Background This study prospectively examined the natural clinical course of six anxiety disorders over 7 years of follow-up in individuals with personality disorders (PDs) and/or major depressive disorder. Rates of remission, relapse, new episode onset and chronicity of anxiety disorders were examined for specific associations with PDs. Method Participants were 499 patients with anxiety disorders in the Collaborative Longitudinal Personality Disorders Study, who were assessed with structured interviews for psychiatric disorders at yearly intervals throughout 7 years of follow-up. These data were used to determine probabilities of changes in disorder status for social phobia (SP), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder and panic disorder with agoraphobia. Results Estimated remission rates for anxiety disorders in this study group ranged from 73% to 94%. For those patients who remitted from an anxiety disorder, relapse rates ranged from 34% to 67%. Rates for new episode onsets of anxiety disorders ranged from 3% to 17%. Specific PDs demonstrated associations with remission, relapse, new episode onsets and chronicity of anxiety disorders. Associations were identified between schizotypal PD with course of SP, PTSD and GAD; avoidant PD with course of SP and OCD; obsessive-compulsive PD with course of GAD, OCD, and agoraphobia; and borderline PD with course of OCD, GAD and panic with agoraphobia. Conclusions Findings suggest that specific PD diagnoses have negative prognostic significance for the course of anxiety disorders underscoring the importance of assessing and considering PD diagnoses in patients with anxiety disorders.

Original languageEnglish (US)
Pages (from-to)1019-1028
Number of pages10
JournalPsychological medicine
Volume41
Issue number5
DOIs
StatePublished - May 1 2011
Externally publishedYes

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Life Tables
Personality Disorders
Survival Analysis
Anxiety Disorders
Proportional Hazards Models
Comorbidity
Chronic Disease
Prospective Studies
Recurrence
Obsessive-Compulsive Disorder
Agoraphobia
Compulsive Personality Disorder
Panic Disorder
Post-Traumatic Stress Disorders
Schizotypal Personality Disorder
Borderline Personality Disorder
Panic
Major Depressive Disorder
Psychiatry

Keywords

  • anxiety disorders
  • Chronicity
  • personality disorders
  • relapse
  • remission

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

Cite this

Ansell, E. B., Pinto, A., Edelen, M. O., Markowitz, J. C., Sanislow, C. A., Yen, S., ... Grilo, C. M. (2011). The association of personality disorders with the prospective 7-year course of anxiety disorders. Psychological medicine, 41(5), 1019-1028. https://doi.org/10.1017/S0033291710001777

The association of personality disorders with the prospective 7-year course of anxiety disorders. / Ansell, E. B.; Pinto, Anthony; Edelen, M. O.; Markowitz, J. C.; Sanislow, C. A.; Yen, S.; Zanarini, M.; Skodol, A. E.; Shea, M. T.; Morey, L. C.; Gunderson, J. G.; McGlashan, T. H.; Grilo, C. M.

In: Psychological medicine, Vol. 41, No. 5, 01.05.2011, p. 1019-1028.

Research output: Contribution to journalArticle

Ansell, EB, Pinto, A, Edelen, MO, Markowitz, JC, Sanislow, CA, Yen, S, Zanarini, M, Skodol, AE, Shea, MT, Morey, LC, Gunderson, JG, McGlashan, TH & Grilo, CM 2011, 'The association of personality disorders with the prospective 7-year course of anxiety disorders', Psychological medicine, vol. 41, no. 5, pp. 1019-1028. https://doi.org/10.1017/S0033291710001777
Ansell, E. B. ; Pinto, Anthony ; Edelen, M. O. ; Markowitz, J. C. ; Sanislow, C. A. ; Yen, S. ; Zanarini, M. ; Skodol, A. E. ; Shea, M. T. ; Morey, L. C. ; Gunderson, J. G. ; McGlashan, T. H. ; Grilo, C. M. / The association of personality disorders with the prospective 7-year course of anxiety disorders. In: Psychological medicine. 2011 ; Vol. 41, No. 5. pp. 1019-1028.
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abstract = "Background This study prospectively examined the natural clinical course of six anxiety disorders over 7 years of follow-up in individuals with personality disorders (PDs) and/or major depressive disorder. Rates of remission, relapse, new episode onset and chronicity of anxiety disorders were examined for specific associations with PDs. Method Participants were 499 patients with anxiety disorders in the Collaborative Longitudinal Personality Disorders Study, who were assessed with structured interviews for psychiatric disorders at yearly intervals throughout 7 years of follow-up. These data were used to determine probabilities of changes in disorder status for social phobia (SP), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder and panic disorder with agoraphobia. Results Estimated remission rates for anxiety disorders in this study group ranged from 73{\%} to 94{\%}. For those patients who remitted from an anxiety disorder, relapse rates ranged from 34{\%} to 67{\%}. Rates for new episode onsets of anxiety disorders ranged from 3{\%} to 17{\%}. Specific PDs demonstrated associations with remission, relapse, new episode onsets and chronicity of anxiety disorders. Associations were identified between schizotypal PD with course of SP, PTSD and GAD; avoidant PD with course of SP and OCD; obsessive-compulsive PD with course of GAD, OCD, and agoraphobia; and borderline PD with course of OCD, GAD and panic with agoraphobia. Conclusions Findings suggest that specific PD diagnoses have negative prognostic significance for the course of anxiety disorders underscoring the importance of assessing and considering PD diagnoses in patients with anxiety disorders.",
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AU - Zanarini, M.

AU - Skodol, A. E.

AU - Shea, M. T.

AU - Morey, L. C.

AU - Gunderson, J. G.

AU - McGlashan, T. H.

AU - Grilo, C. M.

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N2 - Background This study prospectively examined the natural clinical course of six anxiety disorders over 7 years of follow-up in individuals with personality disorders (PDs) and/or major depressive disorder. Rates of remission, relapse, new episode onset and chronicity of anxiety disorders were examined for specific associations with PDs. Method Participants were 499 patients with anxiety disorders in the Collaborative Longitudinal Personality Disorders Study, who were assessed with structured interviews for psychiatric disorders at yearly intervals throughout 7 years of follow-up. These data were used to determine probabilities of changes in disorder status for social phobia (SP), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder and panic disorder with agoraphobia. Results Estimated remission rates for anxiety disorders in this study group ranged from 73% to 94%. For those patients who remitted from an anxiety disorder, relapse rates ranged from 34% to 67%. Rates for new episode onsets of anxiety disorders ranged from 3% to 17%. Specific PDs demonstrated associations with remission, relapse, new episode onsets and chronicity of anxiety disorders. Associations were identified between schizotypal PD with course of SP, PTSD and GAD; avoidant PD with course of SP and OCD; obsessive-compulsive PD with course of GAD, OCD, and agoraphobia; and borderline PD with course of OCD, GAD and panic with agoraphobia. Conclusions Findings suggest that specific PD diagnoses have negative prognostic significance for the course of anxiety disorders underscoring the importance of assessing and considering PD diagnoses in patients with anxiety disorders.

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