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Ann O. Massion, MD; Ingrid R. Dyck, MPH; M. Tracie Shea, PhD; Katharine A. Phillips, MD; Meredith G. Warshaw, MSS, MA; Martin B. Keller, MD

Arch Gen Psychiatry. 2002;59:434-440.

Background  This investigation assessed the effect of personality disorders (PersDs) on time to remission in patients with generalized anxiety disorder, social phobia, or panic disorder.

Methods  Selected Axis I and II predictors of time to remission during 5 years of follow-up were assessed in 514 patients with 1 or more of these anxiety disorders who participated in the Harvard/Brown Anxiety Research Program, a multisite, prospective, longitudinal, naturalistic study.

Results  The presence of a PersD predicted a 30% lower likelihood of generalized anxiety disorder remission, a 39% lower likelihood of social phobia remission, and no difference in likelihood of panic disorder remission. More specifically, a lower likelihood of remission from generalized anxiety disorder was predicted by the presence of avoidant PersD (34% lower) and dependent PersD (14% lower). The presence of avoidant PersD predicted a 41% lower likelihood of social phobia remission. The presence of major depressive disorder did not account for these findings.

Conclusions  Our findings provide new data on the pernicious effect of PersDs on the course of generalized anxiety disorder and social phobia but not panic disorder, suggesting that PersDs have a differential effect on the outcome of anxiety disorders.

From the Department of Psychiatry, University of Massachusetts Medical School, Worcester (Dr Massion); the Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, RI (Drs Shea, Phillips, and Keller and Ms Dyck); and the Massachusetts Veterans Epidemiology Research and Information Center, Boston VA Healthcare System, and Department of Epidemiology and Biostatistics, Boston University School of Public Health (Ms Warshaw). Drs Shea, Phillips, and Keller are or have been consultants for, received honoraria or grant support from, or serve on the advisory board of several pharmaceutical companies.

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