background It is largely unknown whether continuous symptom dimensions provide additional prognostic power compared to categorical dsm-iv diagnoses.
aim To investigate the ability of symptom dimensions and to predict the rate of remission and the occurrence of different course trajectories of psychopathology over a two-year period.
method The study group consisted of 941 subjects with a depressive and/or anxiety disorder from primary and specialized mental health care. Structured, dsm-iv based interviews and Life Chart Assessment allowed assessment of disease course over time. The dimensions of the tripartite model (general distress, anhedonic depression and anxious arousal) were assessed with the short adaptation of the mood and anxiety symptoms questionnaire (masq-d30). The Mood/Cognition and Anxiety/Arousal dimensions were derived from the Inventory of Depressive Symptomatology Self-Report (ids-sr).
results Increased general distress was associated with less remission and unfavourable course trajectories in both depression and anxiety. Increased anhedonic depression and mood/cognition were associated with less remission and unfavourable course trajectories in depression. These dimensions added predictive information above and beyond other predictor variables, such as overall severity, duration of the index disorder and the type of dsm-iv diagnosis at baseline. Anxious arousal and anxiety/arousal did not show any specific predictive abilities in anxiety patients.
conclusion Several symptom dimensions provide unique prognostic information about the course of psychopathology, which makes them potentially very useful for clinical practice and longitudinal research.