Martin B. Keller, MD
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Although generalized anxiety disorder (GAD) is a common disorder associated with significant
levels of morbidity, little is known of its long-term course and outcomes. During the first 5 years,
GAD follows a chronic course with low rates of remission and moderate rates of relapse/recurrence
following remission. Retrospective studies suggest that this chronic pattern may last up to 20 years. It
is hoped that, as with depression, long-term prospective studies in GAD will provide insight into the
course, nature, and outcomes of the disorder over time. The studies will also identify any changes in
the duration and severity of episodes of GAD over time, enabling treatments to effectively reflect the
course of the disorder. Studies of other anxiety disorders and depression suggest that the course and
outcome of the disorder may be influenced by certain factors such as stressful life events, anxiety
sensitivity/negative affect, gender, subsyndromal symptoms, and comorbid disorders. Currently, studies
are underway to determine the effects of these factors on the risk of relapse/recurrence, maintenance
of full symptoms, and development of subsyndromal symptoms in GAD. GAD is currently
underrecognized and undertreated, but it is hoped that this will change with the ever-increasing awareness
of anxiety disorders. As treatment for GAD becomes more common, future prospective studies
will identify the effect of therapy on the course and nature of the disorder, leading to increased
understanding of GAD and the development of effective treatment strategies tailored for individual
patients.
J Clin Psychiatry 2002;63(suppl 8):11-16
© Copyright 2002 Physicians Postgraduate Press, Inc.