Symptom dimensions as predictors of the two-year course of depressive and anxiety disorders

Background: Because 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. Methods: A sample of 992 subjects with depressive and/or anxiety disorders was followed in a 2-year prospective cohort study. Dimensions of the tripartite 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. Results: Dimensional 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. Limitations: Only prevalent patients were included at baseline and only three dimensions were measured Conclusions: Symptom 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. © 2011 Elsevier B.V. All rights reserved.