Duration of untreated illness as a predictor of treatment response and clinical course in generalized anxiety disorder. Export

@article{citeulike:2880611, abstract = {INTRODUCTION: The aim of the present study was to investigate the impact of the duration of untreated illness (DUI)-defined as the time elapsing between the onset of generalized anxiety disorder (GAD) and the first adequate pharmacologic treatment-on treatment response and clinical course in a sample of subjects with GAD. METHODS: One hundred patients with GAD, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision criteria, were enrolled and their main demographic and clinical features collected. Patients were then treated with selective serotonin reuptake inhibitors or venlafaxine for 8 weeks in open-label conditions. Treatment response and other clinical variables were analyzed after dividing the sample into two groups according to DUI (DUI <or=12 months and DUI >12 months). RESULTS: When the DUI was computed with respect to the first antidepressant treatment (DUI-AD), a higher improvement (Clinical Global Impressions-Severity of Illness scale) after the pharmacologic treatment was found in the group with a shorter DUI (analysis of variance with repeated measures: time effect F=654.975, P<.001; group effect: F=4.369, P=.039). When computed with respect to the first treatment with benzodiazepines (DUI-BDZ), the two groups did not show any significant difference in treatment response (time effect: F=652.183, P<.001; group effect: F=0.009, P=.924). In addition, patients with a longer DUI (DUI-BDZ or DUI-AD) showed an earlier age at onset, a longer duration of illness and a higher rate of comorbid psychiatric disorders with onset later than GAD. CONCLUSION: Results from this preliminary study seem to suggest that a shorter DUI-AD may determine a better response to pharmacologic treatment in patients with GAD, and that a longer DUI (DUI-BDZ and DUI-AD) may be associated to a worse clinical course. Further investigation on the relationship between DUI and GAD is needed.}, address = {Department of Psychiatry, University of Milan, Milan, Italy.}, author = {Altamura, A. C. and Dell'osso, B. and D'Urso, N. and Russo, M. and Fumagalli, S. and Mundo, E.}, citeulike-article-id = {2880611}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/18496479}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=18496479}, issn = {1092-8529}, journal = {CNS spectrums}, keywords = {anti\_depressant, clinical\_trial, gabaergic, gad}, month = {May}, number = {5}, pages = {415--422}, posted-at = {2008-06-10 19:28:09}, priority = {0}, title = {Duration of untreated illness as a predictor of treatment response and clinical course in generalized anxiety disorder.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/18496479}, volume = {13}, year = {2008} }

TY - JOUR ID - citeulike:2880611 L3 - citeulike-article-id:2880611 N2 - INTRODUCTION: The aim of the present study was to investigate the impact of the duration of untreated illness (DUI)-defined as the time elapsing between the onset of generalized anxiety disorder (GAD) and the first adequate pharmacologic treatment-on treatment response and clinical course in a sample of subjects with GAD. METHODS: One hundred patients with GAD, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision criteria, were enrolled and their main demographic and clinical features collected. Patients were then treated with selective serotonin reuptake inhibitors or venlafaxine for 8 weeks in open-label conditions. Treatment response and other clinical variables were analyzed after dividing the sample into two groups according to DUI (DUI <or=12 months and DUI >12 months). RESULTS: When the DUI was computed with respect to the first antidepressant treatment (DUI-AD), a higher improvement (Clinical Global Impressions-Severity of Illness scale) after the pharmacologic treatment was found in the group with a shorter DUI (analysis of variance with repeated measures: time effect F=654.975, P<.001; group effect: F=4.369, P=.039). When computed with respect to the first treatment with benzodiazepines (DUI-BDZ), the two groups did not show any significant difference in treatment response (time effect: F=652.183, P<.001; group effect: F=0.009, P=.924). In addition, patients with a longer DUI (DUI-BDZ or DUI-AD) showed an earlier age at onset, a longer duration of illness and a higher rate of comorbid psychiatric disorders with onset later than GAD. CONCLUSION: Results from this preliminary study seem to suggest that a shorter DUI-AD may determine a better response to pharmacologic treatment in patients with GAD, and that a longer DUI (DUI-BDZ and DUI-AD) may be associated to a worse clinical course. Further investigation on the relationship between DUI and GAD is needed. IS - 5 JF - CNS spectrums SN - 1092-8529 AD - Department of Psychiatry, University of Milan, Milan, Italy. EP - 422 TI - Duration of untreated illness as a predictor of treatment response and clinical course in generalized anxiety disorder. VL - 13 SP - 415 KW - anti_depressant KW - clinical_trial KW - gabaergic KW - gad AU - Altamura, AC AU - Dell'osso, B AU - D'Urso, N AU - Russo, M AU - Fumagalli, S AU - Mundo, E PY - 2008/05// UR - http://view.ncbi.nlm.nih.gov/pubmed/18496479 ER -