Author's Accepted Manuscript
Disability in Anxiety Disorders Sanne M. Hendriks, Jan Spijker, Carmilla M.M. Licht, Aartjan T.F. Beekman, Florian Hardeveld, Ron de Graaf, Neeltje M. Batelaan, Brenda W.J. H. Penninx
www.elsevier.com/locate/jad
PII: DOI: Reference:
S0165-0327(14)00278-X http://dx.doi.org/10.1016/j.jad.2014.05.006 JAD6751
To appear in:
Journal of Affective Disorders
Received date: 9 December 2013 Revised date: 28 April 2014 Accepted date: 1 May 2014 Cite this article as: Sanne M. Hendriks, Jan Spijker, Carmilla M.M. Licht, Aartjan T.F. Beekman, Florian Hardeveld, Ron de Graaf, Neeltje M. Batelaan, Brenda W.J.H. Penninx, Disability in Anxiety Disorders, Journal of Affective Disorders, http://dx.doi.org/10.1016/j.jad.2014.05.006 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
DISABILITY IN ANXIETY DISORDERS
Sanne M. Hendriks, Jan Spijker, Carmilla M.M. Licht, Aartjan T.F. Beekman, Florian Hardeveld, Ron de Graaf, Neeltje M. Batelaan, Brenda W.J.H. Penninx
AUTHOR AFFILIATIONS Sanne M. Hendriks, MD, Department of Psychiatry, Pro Persona Mental Health Care, Ede, The Netherlands; Jan Spijker, MD, Department of Psychiatry, Pro Persona Mental Health Care, Nijmegen, Behavourial Science Institute, Radboud University, Nijmegen, and Institute of Mental Health and Addiction, Utrecht, The Netherlands; Carmilla M.M. Licht, PhD, VU University Medical Center, Department of Psychiatry/EMGO Institute/Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Aartjan T.F. Beekman, MD, VU University Medical Center, Department of Psychiatry/EMGO Institute/Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Florian Hardeveld, MD, Department of Psychiatry, Pro Persona Mental Health Care, Ede, The Netherlands; Ron de Graaf, PhD, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; Neeltje M. Batelaan, MD, VU University Medical Center and GGZIngeest, Department of Psychiatry/EMGO Institute/Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Brenda W.J.H. Penninx, PhD, VU University Medical Center, Department of Psychiatry/EMGO Institute/Neuroscience Campus Amsterdam, Amsterdam, and University Medical Center Groningen, Department of Psychiatry, University of Groningen, Groningen, and Leiden University Medical Center, Department of Psychiatry, Leiden, The Netherlands.
CORRESPONDING AUTHOR: Sanne M. Hendriks, MD, Department of Psychiatry, Pro Persona Mental Health Care, Willy Brandtlaan 20, 6717 RR Ede, The Netherlands. Phone: + 31 318 433400, Fax + 31 318 433688, [email protected].
1
ABSTRACT
Background: This study compares disability levels between different anxiety disorders and healthy controls. We further investigate the role of anxiety arousal and avoidance behaviour in disability, and whether differences in these symptom patterns contribute to disability differences between anxiety disorders.
Methods: Data were from 1826 subjects from the Netherlands Study of Depression and Anxiety (NESDA). The Composite Interview Diagnostic Instrument was used to diagnose anxiety disorders. The World Health Organization Disability Assessment Schedule II was used to measure disability in six domains (cognition, mobility, selfcare, social interaction, life activities, participation). Severity of anxiety arousal and avoidance behaviour symptoms was measured using the Beck Anxiety Inventory and the Fear Questionnaire.
Results: All anxiety disorders were associated with higher disability. Disability was generally highest in multiple anxiety disorder (e.g. mean disability in cognition = 33.7) and social anxiety disorder (mean = 32.7), followed by generalized anxiety disorder (mean = 27.2) and panic disorder with agoraphobia (mean = 26.3), and lowest in panic disorder without agoraphobia (mean = 22.1). Anxiety arousal was more associated with disability in life activities (B = 8.5, p
Disability in Anxiety Disorders Sanne M. Hendriks, Jan Spijker, Carmilla M.M. Licht, Aartjan T.F. Beekman, Florian Hardeveld, Ron de Graaf, Neeltje M. Batelaan, Brenda W.J. H. Penninx
www.elsevier.com/locate/jad
PII: DOI: Reference:
S0165-0327(14)00278-X http://dx.doi.org/10.1016/j.jad.2014.05.006 JAD6751
To appear in:
Journal of Affective Disorders
Received date: 9 December 2013 Revised date: 28 April 2014 Accepted date: 1 May 2014 Cite this article as: Sanne M. Hendriks, Jan Spijker, Carmilla M.M. Licht, Aartjan T.F. Beekman, Florian Hardeveld, Ron de Graaf, Neeltje M. Batelaan, Brenda W.J.H. Penninx, Disability in Anxiety Disorders, Journal of Affective Disorders, http://dx.doi.org/10.1016/j.jad.2014.05.006 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
DISABILITY IN ANXIETY DISORDERS
Sanne M. Hendriks, Jan Spijker, Carmilla M.M. Licht, Aartjan T.F. Beekman, Florian Hardeveld, Ron de Graaf, Neeltje M. Batelaan, Brenda W.J.H. Penninx
AUTHOR AFFILIATIONS Sanne M. Hendriks, MD, Department of Psychiatry, Pro Persona Mental Health Care, Ede, The Netherlands; Jan Spijker, MD, Department of Psychiatry, Pro Persona Mental Health Care, Nijmegen, Behavourial Science Institute, Radboud University, Nijmegen, and Institute of Mental Health and Addiction, Utrecht, The Netherlands; Carmilla M.M. Licht, PhD, VU University Medical Center, Department of Psychiatry/EMGO Institute/Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Aartjan T.F. Beekman, MD, VU University Medical Center, Department of Psychiatry/EMGO Institute/Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Florian Hardeveld, MD, Department of Psychiatry, Pro Persona Mental Health Care, Ede, The Netherlands; Ron de Graaf, PhD, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; Neeltje M. Batelaan, MD, VU University Medical Center and GGZIngeest, Department of Psychiatry/EMGO Institute/Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Brenda W.J.H. Penninx, PhD, VU University Medical Center, Department of Psychiatry/EMGO Institute/Neuroscience Campus Amsterdam, Amsterdam, and University Medical Center Groningen, Department of Psychiatry, University of Groningen, Groningen, and Leiden University Medical Center, Department of Psychiatry, Leiden, The Netherlands.
CORRESPONDING AUTHOR: Sanne M. Hendriks, MD, Department of Psychiatry, Pro Persona Mental Health Care, Willy Brandtlaan 20, 6717 RR Ede, The Netherlands. Phone: + 31 318 433400, Fax + 31 318 433688, [email protected].
1
ABSTRACT
Background: This study compares disability levels between different anxiety disorders and healthy controls. We further investigate the role of anxiety arousal and avoidance behaviour in disability, and whether differences in these symptom patterns contribute to disability differences between anxiety disorders.
Methods: Data were from 1826 subjects from the Netherlands Study of Depression and Anxiety (NESDA). The Composite Interview Diagnostic Instrument was used to diagnose anxiety disorders. The World Health Organization Disability Assessment Schedule II was used to measure disability in six domains (cognition, mobility, selfcare, social interaction, life activities, participation). Severity of anxiety arousal and avoidance behaviour symptoms was measured using the Beck Anxiety Inventory and the Fear Questionnaire.
Results: All anxiety disorders were associated with higher disability. Disability was generally highest in multiple anxiety disorder (e.g. mean disability in cognition = 33.7) and social anxiety disorder (mean = 32.7), followed by generalized anxiety disorder (mean = 27.2) and panic disorder with agoraphobia (mean = 26.3), and lowest in panic disorder without agoraphobia (mean = 22.1). Anxiety arousal was more associated with disability in life activities (B = 8.5, p
