Cargando…

A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders

Anxiety disorders are highly comorbid with each other and with other serious mental disorders. As our field progresses, we have the opportunity to pursue treatment study designs that consider these comorbidities. In this perspective review, we first characterized the prevalence of multiple anxiety d...

Descripción completa

Detalles Bibliográficos
Autores principales: Goldstein-Piekarski, A N, Williams, L M, Humphreys, K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931606/
https://www.ncbi.nlm.nih.gov/pubmed/27351601
http://dx.doi.org/10.1038/tp.2016.108
_version_ 1782440927891030016
author Goldstein-Piekarski, A N
Williams, L M
Humphreys, K
author_facet Goldstein-Piekarski, A N
Williams, L M
Humphreys, K
author_sort Goldstein-Piekarski, A N
collection PubMed
description Anxiety disorders are highly comorbid with each other and with other serious mental disorders. As our field progresses, we have the opportunity to pursue treatment study designs that consider these comorbidities. In this perspective review, we first characterized the prevalence of multiple anxiety disorder comorbidity by reanalyzing national survey data, then conducted an English-language PubMed search of studies analyzing the impact of exclusion criteria on treatment outcome data. In the prevalence data, 60% of people with an anxiety disorder had one or more additional anxiety or depression diagnosis. Because our commonly applied exclusion criteria focus on a single diagnosis and do not consider a multiple comorbidity profile, the impact of the criteria may be to exclude up to 92% of anxiety disorder treatment seekers. Moreover, the findings do not suggest a consistent relationship between the number of exclusion criteria and the effect size of treatment outcomes. Thus, future studies might consider a more trans-diagnostic rationale for determining exclusion criteria, one that is generalizable to real-world settings in which multiple diagnoses commonly co-occur. The findings also encourage a more systematic reporting of rationales for the choice of—and the implications of—each exclusion criterion.
format Online
Article
Text
id pubmed-4931606
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Nature Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-49316062016-07-05 A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders Goldstein-Piekarski, A N Williams, L M Humphreys, K Transl Psychiatry Perspectives Anxiety disorders are highly comorbid with each other and with other serious mental disorders. As our field progresses, we have the opportunity to pursue treatment study designs that consider these comorbidities. In this perspective review, we first characterized the prevalence of multiple anxiety disorder comorbidity by reanalyzing national survey data, then conducted an English-language PubMed search of studies analyzing the impact of exclusion criteria on treatment outcome data. In the prevalence data, 60% of people with an anxiety disorder had one or more additional anxiety or depression diagnosis. Because our commonly applied exclusion criteria focus on a single diagnosis and do not consider a multiple comorbidity profile, the impact of the criteria may be to exclude up to 92% of anxiety disorder treatment seekers. Moreover, the findings do not suggest a consistent relationship between the number of exclusion criteria and the effect size of treatment outcomes. Thus, future studies might consider a more trans-diagnostic rationale for determining exclusion criteria, one that is generalizable to real-world settings in which multiple diagnoses commonly co-occur. The findings also encourage a more systematic reporting of rationales for the choice of—and the implications of—each exclusion criterion. Nature Publishing Group 2016-06 2016-06-28 /pmc/articles/PMC4931606/ /pubmed/27351601 http://dx.doi.org/10.1038/tp.2016.108 Text en Copyright © 2016 Macmillan Publishers Limited http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Perspectives
Goldstein-Piekarski, A N
Williams, L M
Humphreys, K
A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders
title A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders
title_full A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders
title_fullStr A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders
title_full_unstemmed A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders
title_short A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders
title_sort trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders
topic Perspectives
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931606/
https://www.ncbi.nlm.nih.gov/pubmed/27351601
http://dx.doi.org/10.1038/tp.2016.108
work_keys_str_mv AT goldsteinpiekarskian atransdiagnosticreviewofanxietydisordercomorbidityandtheimpactofmultipleexclusioncriteriaonstudyingclinicaloutcomesinanxietydisorders
AT williamslm atransdiagnosticreviewofanxietydisordercomorbidityandtheimpactofmultipleexclusioncriteriaonstudyingclinicaloutcomesinanxietydisorders
AT humphreysk atransdiagnosticreviewofanxietydisordercomorbidityandtheimpactofmultipleexclusioncriteriaonstudyingclinicaloutcomesinanxietydisorders
AT goldsteinpiekarskian transdiagnosticreviewofanxietydisordercomorbidityandtheimpactofmultipleexclusioncriteriaonstudyingclinicaloutcomesinanxietydisorders
AT williamslm transdiagnosticreviewofanxietydisordercomorbidityandtheimpactofmultipleexclusioncriteriaonstudyingclinicaloutcomesinanxietydisorders
AT humphreysk transdiagnosticreviewofanxietydisordercomorbidityandtheimpactofmultipleexclusioncriteriaonstudyingclinicaloutcomesinanxietydisorders