TY - JOUR
T1 - Transdiagnostic factors predicting the 2-year disability outcome in patients with anxiety and depressive disorders
AU - Ruitenberg, G. Margaret
AU - Booij, S. H. Sanne
AU - Batelaan, N. M. Neeltje
AU - Hoogendoorn, A. W. Adriaan
AU - Visser, H. A. Henny
N1 - Funding Information: NA Publisher Copyright: © 2023, The Author(s).
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: Both anxiety and depressive disorders are associated with significant long-term disability. Since experienced impairments vary between patients independent of diagnosis and disease severity, identifying transdiagnostic factors that predict the course of disability may provide new targets to reduce disability. This study examines transdiagnostic factors predicting the 2-year disability outcome in patients with anxiety and/or depressive disorders (ADD), focusing on potentially malleable factors. Methods: Six hundred fifteen participants with a current diagnosis of ADD from the Netherlands Study of Depression and Anxiety (NESDA) were included. Disability was assessed at baseline and after 2 years of follow-up, using the 32-item WHODAS II questionnaire. Transdiagnostic predictors of 2-year disability outcome were identified using linear regression analysis. Results: In univariable analyses, transdiagnostic factors associated with the 2-year disability outcome were locus of control (standardized β = -0.116, p = 0.011), extraversion (standardized β = -0.123 p = 0.004) and experiential avoidance (standardized β = 0.139, p = 0.001). In multivariable analysis, extraversion had a unique predictive value (standardized β = -0.143 p = 0.003). A combination of sociodemographic, clinical and transdiagnostic variables resulted in an explained variance (R2) of 0.090). The explained variance of a combination of transdiagnostic factors was 0.050. Conclusion: The studied transdiagnostic variables explain a small but unique part of variability in the 2-year disability outcome. Extraversion is the only malleable transdiagnostic factor predictive of the course of disability independent of other variables. Due to the small contribution to the variance in the disability outcome, the clinical relevance of targeting extraversion seems limited. However, its predictive value is comparable to that of accepted disease severity measures, supporting the importance of looking beyond using disease severity measures as predictors. Furthermore, studies including extraversion in combination with other transdiagnostic and environmental factors may elucidate the unexplained part of variability of the course of disability in patients with ADD.
AB - Background: Both anxiety and depressive disorders are associated with significant long-term disability. Since experienced impairments vary between patients independent of diagnosis and disease severity, identifying transdiagnostic factors that predict the course of disability may provide new targets to reduce disability. This study examines transdiagnostic factors predicting the 2-year disability outcome in patients with anxiety and/or depressive disorders (ADD), focusing on potentially malleable factors. Methods: Six hundred fifteen participants with a current diagnosis of ADD from the Netherlands Study of Depression and Anxiety (NESDA) were included. Disability was assessed at baseline and after 2 years of follow-up, using the 32-item WHODAS II questionnaire. Transdiagnostic predictors of 2-year disability outcome were identified using linear regression analysis. Results: In univariable analyses, transdiagnostic factors associated with the 2-year disability outcome were locus of control (standardized β = -0.116, p = 0.011), extraversion (standardized β = -0.123 p = 0.004) and experiential avoidance (standardized β = 0.139, p = 0.001). In multivariable analysis, extraversion had a unique predictive value (standardized β = -0.143 p = 0.003). A combination of sociodemographic, clinical and transdiagnostic variables resulted in an explained variance (R2) of 0.090). The explained variance of a combination of transdiagnostic factors was 0.050. Conclusion: The studied transdiagnostic variables explain a small but unique part of variability in the 2-year disability outcome. Extraversion is the only malleable transdiagnostic factor predictive of the course of disability independent of other variables. Due to the small contribution to the variance in the disability outcome, the clinical relevance of targeting extraversion seems limited. However, its predictive value is comparable to that of accepted disease severity measures, supporting the importance of looking beyond using disease severity measures as predictors. Furthermore, studies including extraversion in combination with other transdiagnostic and environmental factors may elucidate the unexplained part of variability of the course of disability in patients with ADD.
KW - Anxiety and depressive disorders
KW - Disability outcome
KW - Experiential avoidance
KW - Extraversion
KW - Locus of control
KW - NESDA
KW - Transdiagnostic factor
KW - WHODAS II
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85162070934&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/37328822
UR - http://www.scopus.com/inward/record.url?scp=85162070934&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12888-023-04919-1
DO - https://doi.org/10.1186/s12888-023-04919-1
M3 - Article
C2 - 37328822
SN - 1471-244X
VL - 23
JO - BMC psychiatry
JF - BMC psychiatry
IS - 1
M1 - 443
ER -