By Eric J.L. Griez
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Extra resources for Anxiety Disorders An Introduction to Clinical Management and Research
Natural Course Obsessive-compulsive disorder has a chronic course, and few patients achieve true remission. Although symptoms may ﬂuctuate over time, the disorder rarely is resolved spontaneously without appropriate treatment (Goodman, 1999). Full remission of OCD symptoms is rare, but episodic improvement in OCD symptoms is not uncommon (Pigott, 1998). In a 40-year follow-up of 122 OCD patients, Skoog and Skoog (1999) substantiated these generalities: 20% achieved complete recovery, 28% recovery with subclinical symptoms, another 35% still had clinical symptoms but did improve.
Comorbidity As is the case for panic disorder, in social phobia as well, the comorbidity rate is high. Around 80% of social phobia co-exists with other disorders (Le´ pine and Pelissolo, 1996; Montgomery, 1998). In particular, lifetime depression is high, about 70%, as well as other anxiety disorders. , 1991). However, this study only comprised 57 subjects. , 1993). , 1996). , 1992). The relationship between social phobia and alcoholism is a complex one. Reported prevalence rates vary widely, due to diﬀering deﬁnitions, and methodological differences (Le´ pine and Pelissolo, 1998).
Some 48% had had obsessive-compulsive disorder for more than 30 years. Comorbidity Depression is the most frequent complication of OCD, as reported in several studies (Black and Noyes, 1990). , 1995). Within this wide range, however, most epidemiological studies show that about one-third of OCD patients suﬀer from a lifetime depressive episode. In clinical populations, comorbidity rates are increasing to about two-thirds (Crino and Andrews, 1996). Rasmussen found that one-third of OCD patients suﬀer from concurrent depression at referral, and two-thirds suﬀer from lifetime depression (Rasmussen and Eisen, 1994), a similar ﬁnding as in panic disorder.