Disability in anxiety disorders.
BACKGROUND: This study compares disability levels between different anxiety disorders and healthy controls. We further investigate the role of anxiety arousal and avoidance behaviour in disability, and whether differences in these symptom patterns contribute to disability differences between anxiety disorders
METHODS: Data were from 1826 subjects from the Netherlands Study of Depression and Anxiety (NESDA). The Composite Interview Diagnostic Instrument was used to diagnose anxiety disorders. The World Health Organization Disability Assessment Schedule II was used to measure disability in six domains (cognition, mobility, selfcare, social interaction, life activities, participation). Severity of anxiety arousal and avoidance behaviour symptoms was measured using the Beck Anxiety Inventory and the Fear Questionnaire.
RESULTS: All anxiety disorders were associated with higher disability. Disability was generally highest in multiple anxiety disorder (e.g. mean disability in cognition=33.7) and social anxiety disorder (mean=32.7), followed by generalized anxiety disorder (mean=27.2) and panic disorder with agoraphobia (mean=26.3), and lowest in panic disorder without agoraphobia (mean=22.1). Anxiety arousal was more associated with disability in life activities (B=8.5, p<0.001) and participation (B=9.9, p<0.001) whereas avoidance behaviour was more associated with disability in cognition (B=7.4, p<0.001) and social interaction (B=8.6, p<0.001). Different disability patterns between anxiety disorders were not completely explained by anxiety arousal and avoidance behaviour.
LIMITATIOTIONS: The cross-sectional study design precludes any causal interpretations. In order to examine the full range of comorbidity among anxiety, a greater range of anxiety disorders would have been preferable.
CONCLUSIONS: Disability is highest in social anxiety disorder and multiple anxiety disorder. Both anxiety arousal and avoidance behaviour are associated with higher disability levels but do not fully explain the differences across anxiety disorders.
Copyright © 2014 Elsevier B.V. All rights reserveKEYWORDS:Anxiety arousal; Anxiety disorder; Avoidance behaviour; Disability'PMID: 25012435 DOI: 10.1016/j.jad.2014.05.006 [Indexed for MEDLINE]
Day after day I felt it couldn't continue to burn myself out. I looked up at the sky and begged for silence, rest and peace.
I was fatally tired and the last straw had manifest; my partner abandoned me and moved on. Shortly after, circumstances took their toll and I collapsed..
All in all, I spent 6 months in total isolation and silence. During this time, I went through absolute mental and physical fasting. I also met twice with the other side, which was the scariest moments in my life, but allowed me to experience a deeper insight - a sense of enlightenment.
In other words, I gathered my desire and the last willpower and after 100% focus on myself and my healing:
- I walked out of bed after 2 months in 5 days;
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Within the healing time, I had to go through all my unsolved pain and injuries from the past and worked with that at the same time in order to allow myself to naturally heal, no drugs or experiments involved.
To be fully healed and feel no more pain or suffering we have to give it enough focus to ascertain the roots thereof!
Today I am infinitely grateful for the blessings I received and I am now, in turn, to inspired to use my gifts to help and heal others!
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