Healthcare costs and quality of life associated with the long-term outcome of anxiety disorders

Anxiety Stress Coping. 2021 Mar;34(2):228-241. doi: 10.1080/10615806.2020.1839731. Epub 2020 Oct 27.

Abstract

Background and objectives: Anxiety disorders are costly; however, the relationship with treatment outcome has been neglected. This study examined healthcare costs and quality of life by diagnostic status (treatment outcome and the presence of comorbidity) at long-term follow-up.

Design and methods: This cohort study comprized 317 patients entering treatment for at least one Axis I anxiety disorder. Four groups were identified based on diagnostic status at follow-up (recovered or disordered) and self-reported degree of interim treatment (high or low). A further grouping was established based on co-morbid diagnostic status at follow-up. Healthcare costs were calculated for the two years prior to treatment entry and the two years prior to follow-up using a repeated measures analysis of variance (ANOVA). Group differences in quality of life were assessed using a univariate ANOVA.

Results: Over two thirds of the sustained recovery group was treatment-free at follow-up whilst the remainder required adjuvant drug therapy. Over half of those remaining disordered at follow-up incurred substantial healthcare costs and presented with treatment-resistant symptoms and severely impaired quality of life.

Conclusions: Despite substantial investment some patients were associated with a clinical anxiety diagnosis at follow-up, and multimorbidity was associated with considerably higher costs.

Keywords: Anxiety disorders; Healthcare costs; Long-term follow-up; Quality of life; Treatment outcomes.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety Disorders / economics*
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy / economics*
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Follow-Up Studies
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Quality of Life / psychology*
  • Scotland
  • Treatment Outcome
  • Young Adult