Inpatient psychosomatic treatment of anxiety disorders: Comorbidities, predictors, and outcomes

Anxiety disorders pose a challenge for mental health care due to their high prevalence rates and chronic course. The purposes of this survey descriptive study are to explore prevalences and comorbidities of anxiety disorders in multimodal psychotherapeutic inpatient treatment and to determine treatment effectiveness and its predictors. In a total of 37.052 consecutive patients treated in 17 psychosomatic clinics, patients and therapists were queried independently before and after therapy. The main outcome measure was the reduction of the Global Severity Index (GSI) of the SCL-90-R, the secondary outcome was the standardized therapist rating of physical, mental and social impairment. Anxiety disorders were among the most frequent primary diagnoses affecting 5.022 (13.60%) of the patients. The majority suffered from at least one comorbid mental (80%) and somatic (61%) condition. The overall pre post treatment effect size of the GSI was d = .78, ranging from d = .71 to d = .88. Effect sizes of therapist ratings were higher (.95-1.97). In a multivariate analysis, comorbid eating, anxiety and personality disorders were related to a poorer outcome (GSI), along with a long history of anxiety disorders and continued antidepressive medication. Due to the observational character of the study results should not be interpreted causally.