Recurrence of anxiety disorders and its predictors in the general population

Abstract Background Anxiety disorders frequently recur in clinical populations, but the risk of recurrence of anxiety disorders is largely unknown in the general population. In this study, recurrence of anxiety and its predictors were studied in a large cohort of the adult general population. Methods Baseline, 3-year and 6-year follow-up data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). Respondents (N = 468) who had been in remission for at least a year prior to baseline were included. Recurrence was assessed at 3 and 6 years after baseline, using the Composite International Diagnostic Interview version 3.0. Cumulative recurrence rates were estimated using the number of years since remission of the last anxiety disorder. Furthermore, Cox regression analyses were conducted to investigate predictors of recurrence, using a broad range of putative predictors. Results The estimated cumulative recurrence rate was 2.1% at 1 year, 6.6% at 5 years, 10.6% at 10 years, and 16.2% at 20 years. Univariate regression analyses predicted a shorter time to recurrence for several variables, of which younger age at interview, parental psychopathology, neuroticism and a current depressive disorder remained significant in the, age and gender-adjusted, multivariable regression analysis. Conclusions Recurrence of anxiety disorders in the general population is common and the risk of recurrence extends over a lengthy period of time. In clinical practice, alertness to recurrence, monitoring of symptoms, and quick access to health care in case of recurrence are needed.

• Publication year

  2021

• Venue

  Psychological Medicine

• Publication date

  2021-07-23

• Fields of study

  Medicine, Psychology

• Identifiers
  DOI 10.1017/S0033291721002877PMID 34294172PMCID 10009370
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• SURVIVAL ANALYSIS

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• Prevalence and course of subthreshold anxiety disorder in the general population: A three-year follow-up study.

  2019cited by this paper
• Recurrence and chronicity of major depressive disorder and their risk indicators in a population cohort

  2018influential reference
• The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative

  2017cited by this paper
• Cross-sectional Comparison of the Epidemiology of DSM-5 Generalized Anxiety Disorder Across the Globe

  2017cited by this paper
• Diagnostic instability of recurrence and the impact on recurrence rates in depressive and anxiety disorders.

  2016cited by this paper
• Cross‐national epidemiology of panic disorder and panic attacks in the world mental health surveys

  2016cited by this paper
• Predictors of anxiety recurrence in the Coordinated Anxiety Learning and Management (CALM) trial.

  2015influential reference
• Impact of childhood life events and childhood trauma on the onset and recurrence of depressive and anxiety disorders.

  2015cited by this paper
• Recurrence of major depressive disorder across different treatment settings: results from the NESDA study.

  2013cited by this paper
• Common mental disorder severity and its association with treatment contact and treatment intensity for mental health problems

  2013cited by this paper
• Neuroticism and common mental disorders: meaning and utility of a complex relationship.

  2013cited by this paper
• Longitudinal course of panic disorder with and without agoraphobia using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

  2013influential reference
• Recurrence of anxiety disorders and its predictors.

  2013influential reference
• Prevalence of mental disorders and trends from 1996 to 2009. Results from the Netherlands Mental Health Survey and Incidence Study-2.

  2012cited by this paper
• Prevalence of mental disorders and trends from 1996 to 2009. Results from the Netherlands Mental Health Survey and Incidence Study-2

  2012cited by this paper
• Impact of childhood life events and trauma on the course of depressive and anxiety disorders

  2012cited by this paper
• Age of onset, clinical characteristics, and 15-year course of anxiety disorders in a prospective, longitudinal, observational study.

  2011cited by this paper
• The Netherlands Mental Health Survey and Incidence Study‐2 (NEMESIS‐2): design and methods

  2010cited by this paper
• The Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2): design and methods.

  2010cited by this paper
• Comparative efficacy of antidepressants in preventing relapse in anxiety disorders - a meta-analysis.

  2010cited by this paper
• Predictors of relapse in the second follow-up year post cognitive-behavior therapy for panic disorder.

  2010cited by this paper
• How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment

  2009cited by this paper
• Psychosocial predictors of the onset of anxiety disorders in women: results from a prospective 3-year longitudinal study.

  2009influential reference
• Disability and treatment of specific mental and physical disorders across the world

  2008cited by this paper
• Substance Abuse Treatment, Prevention, and Policy Impact of Parental History of Substance Use Disorders on the Clinical Course of Anxiety Disorders

  2006cited by this paper
• The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication.

  2006cited by this paper
• The structure of genetic and environmental risk factors for anxiety disorders in men and women.

  2005cited by this paper
• Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study.

  2005influential reference
• Relationships among psychosocial functioning, diagnostic comorbidity, and the recurrence of generalized anxiety disorder, panic disorder, and major depression.

  2005influential reference
• Early detection of relapse in panic disorder

  2004cited by this paper
• The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI)

  2004cited by this paper
• Hierarchical Model of Generalized and Specific Vulnerabilities in Anxiety

  2003cited by this paper
• DO PANIC SYMPTOMS DURING PERIODS OF REMISSION PREDICT RELAPSE OF PANIC DISORDER?

  2002cited by this paper
• Predictors of first incidence of DSM‐III‐R psychiatric disorders in the general population: findings from the Netherlands Mental Health Survey and Incidence Study

  2002cited by this paper
• Long-term outcome of panic disorder with agoraphobia treated by exposure

  2001cited by this paper
• Long-term outcome of social phobia treated by exposure

  2001cited by this paper
• Survival Analysis: A Self-Learning Text

  1997cited by this paper
• Initial reliability and validity of the childhood trauma interview: a new multidimensional measure of childhood interpersonal trauma.

  1995cited by this paper
• Long-Term Effects of Behavioural Treatment for Panic Disorder with Agoraphobia

  1995cited by this paper
• The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection

  1992cited by this paper
• THE MOS 36- ITEM SHORT FORM HEALTH SURVEY (SF- 36) CONCEPTUAL FRAMEWORK AND ITEM SELECTION

  1992cited by this paper
• The MOS 36-Item Short-Form Health Survey (SF-36)

  1992cited by this paper
• The List of Threatening Experiences: a subset of 12 life event categories with considerable long-term contextual threat

  1985cited by this paper
• A revised version of the Psychoticism scale.

  1985cited by this paper
• Personality and Mental Illness

  1941cited by this paper

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  2026cites this paper
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  2025cites this paper
• Across Barriers: Blood–Brain and Gut Barrier Signaling in Psychiatric Disorders

  2025cites this paper
• Depression and anxiety: A 3-year follow-up study of associated risk and protective factors among university students.

  2025cites this paper
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  2025cites this paper
• Self-esteem and stress: a structural equation modelling of biosocial determinants, psychological mediators and anxiety among Malaysian undergraduates

  2025cites this paper
• A Retrospective Analysis of the Impact of Electroconvulsive Therapy on Anxiety Symptoms in Patients With Treatment-Resistant Depression.

  2025cites this paper
• Evaluation of an inpatient psychocardiological rehabilitation program in Austria: Psychosocial outcomes of a six-month cohort study

  2025cites this paper
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  2023cites this paper
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  2023cites this paper
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