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

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.