College of Psychiatric and Neurologic Pharmacists

Publication year: 2011Source: Journal of Affective Disorders, Available online 15 December 2011Klaas J. Wardenaar, Erik J. Giltay, Tineke van Veen, Frans G. Zitman, Brenda W.J.H. PenninxBackgroundBecause of the heterogeneity of known predictive factors, course-predictions for depression and anxiety are often unspecific. Therefore, it was investigated whether symptom-dimensions could be used as more specific course-predictors, on top of already known predictors, such as diagnosis and overall severity.MethodsA sample of 992 subjects with depressive and/or anxiety disorders was followed in a 2-year prospective cohort study. Dimensions of thetripartite model(general distress, anhedonic depression and anxious arousal) were assessed at baseline. Diagnostic and course information were assessed at baseline and 2-year follow-up.ResultsDimensional scores at baseline predicted diagnosis after two years and course-trajectories during follow-up. Increased general distress at baseline was associated with comorbid depression–anxiety at follow-up, increased anhedonic depression was associated with single depression and anxious arousal was associated with (comorbid) panic disorders at follow-up. Baseline general distress was associated with an unfavorable course in all patients. All associations were independent and added prognostic information on top of diagnosis and other predictive factors at baseline.LimitationsOnly prevalent patients were included at baseline and only three dimensions were measuredConclusionsSymptom dimensions predict the future 2-year course of depression and anxiety. Importantly, the dimensions yield predictive information on top of diagnosis and other prognostic factors at baseline.

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