Predicting the course of anxiety disorders: The role of biological parameters

Prog Neuropsychopharmacol Biol Psychiatry. 2020 Jul 13:101:109924. doi: 10.1016/j.pnpbp.2020.109924. Epub 2020 Mar 13.

Abstract

Objective: Clinical characteristics appear limited in their ability to predict course of anxiety disorders, therefore we explored the predictive value of biological parameters on course of anxiety disorders.

Methods: 907 persons with an anxiety (panic, social phobia, generalised anxiety) disorder with a baseline and two-year follow-up measure were selected from the Netherlands Study of Depression and Anxiety (NESDA). Previously, three course trajectories were distinguished which vary in terms of symptom severity and chronicity. Baseline clinical parameters like anxiety severity, anxiety duration, and disability were limited in their ability to predict the two-year course. This study explored whether metabolic syndrome, hypothalamic-pituitary-adrenal-axis functioning, inflammation markers, and neuroplasticity were indicators of two-year course and whether these parameters improved the model containing the most predictive clinical parameters only.

Results: Baseline diastolic blood pressure of persons with chronic moderate symptoms was significantly higher than of persons with non-chronic mild symptoms (odds ratio [OR] = 1.18, 95% confidence interval [CI95%] 1.01 to 1.38). Baseline high-density lipid cholesterol of persons with severe chronic symptoms was significantly lower than of persons with non-chronic mild symptoms (OR = 0.77, CI95% 0.62 to 0.96). The predictive ability of both parameters was however low with concordance statistics of 0.55 and 0.57 respectively. Addition of biological parameters did not improve the predictive ability of the model containing the clinical parameters.

Conclusions: In addition to clinical characteristics, biological parameters did not improve the predictive ability of the model for course trajectory of anxiety disorders. Prediction of course trajectory in anxiety disorders remains difficult and warrants further research.

Keywords: Anxiety disorders; BDNF; Course trajectory; HPA-axis; Inflammation markers; Metabolic syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / metabolism*
  • Biomarkers / metabolism
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Hypothalamo-Hypophyseal System / metabolism*
  • Inflammation Mediators / metabolism*
  • Longitudinal Studies
  • Male
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / metabolism
  • Middle Aged
  • Netherlands / epidemiology
  • Pituitary-Adrenal System / metabolism*
  • Psychiatric Status Rating Scales

Substances

  • Biomarkers
  • Inflammation Mediators