Longitudinal associations of multiple physical symptoms with recurrence of depressive and anxiety disorders

Sandra M A Dijkstra-Kersten, Kate Sitnikova, Berend Terluin, Brenda WJH Penninx, Jos W R Twisk, Harm Van Marwijk, Henriëtte van der Horst, Johannes van der Wouden

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Abstract

Aims: Previous research has found that multiple physical symptoms are related to co-occurrence, onset and course of depressive and anxiety disorders. However, little is known about their impact on recurrence of depressive or anxiety disorders. We aimed to examine the longitudinal associations of multiple physical symptoms with recurrence of depressive and anxiety disorders.

Methods: Follow-up data of 584 participants with remitted depressive or anxiety disorders were used from a prospective cohort-study: the Netherlands Study of Depressive and Anxiety disorders. Multiple physical symptoms were measured at baseline (T1) and two-year follow-up (T2) by the Four-Dimensional Symptom Questionnaire (4DSQ) somatization subscale. Recurrence of depressive and anxiety disorders was assessed at two-year (T2) and four-year (T4) follow-up with the Composite International Diagnostic Interview. Logistic Generalized Estimating Equations were used to examine associations of multiple physical symptoms with recurrence of depressive and anxiety disorders. We took residual depressive (IDS-SR) and anxiety (BAI) symptoms into account, as they are the main predictors of recurrence of depressive and anxiety disorders, and examined whether excluding somatic features of residual depressive (IDS-SR mood cognition) and anxiety (BAI subjective scale) symptoms altered our results.

Results: Multiple physical symptoms were significantly associated with recurrence of depression (OR = 1.04, 95%CI = 1.00 to 1.08), anxiety (OR = 1.07, 95%CI = 1.03 to 1.12), and depressive or anxiety disorders (OR = 1.06, 95%CI = 1.02 to 1.10), on average over time. Odds ratios did not change substantially when the IDS-SR mood-cognition and BAI subjective scale were included as covariates, compared to the IDS-SR and BAI.

Conclusions: The presence of multiple physical symptoms was positively related to recurrence of depressive and anxiety disorders, independent of depressive and anxiety symptoms. Knowledge of risk factors for recurrence of depressive and anxiety disorders, suchasthe presence of multiple physical symptoms, could providepossibilities for better targeting interventions to prevent recurrence.
Original languageEnglish
Pages (from-to)146
JournalJournal of psychosomatic research
Volume97
Early online date12 Jun 2017
DOIs
Publication statusPublished - 2017

Keywords

  • Anxiety disorder
  • Depressive disorder
  • Multiple physical symptoms
  • Somatization
  • Recurrence

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