Staging and profiling in clinical practice: To what extent do items on a checklist of staging and profiling predict treatment course in anxiety patients? An exploratory study.

Abstract

Objective: Up to today we remain a long way from identifying the most robust predictors of drop-out and (non-)response for treatment. To enable assigning patients to the right intensity of treatment, the Altrecht Academic Anxiety center (AAA) has developed a Checklist Staging and Profiling (CSP), based on consensus between clinicians and common sense. This exploratory study has investigated whether the CSP can differentiate between different disease stages in anxiety disorders and predict treatment outcome in anxiety patients, based on their stage of illness. Methods: The current study consisted of a retrospective study – using the various questionnaires on symptoms at baseline and follow-up of the AAA – and a prospective study of two months duration. Both studies included anxiety patients of the AAA (specialized mental health care), whose data on background variables and symptoms were collected. Results: The CSP has sufficient internal consistency, and differentiates accurately between the different stages of anxiety disorders. The CSP can reasonably predict the course of treatment in patients with anxiety disorders and also which patients will drop-out if no appropriate measures are taken. Discussion: With some adaptations, the CSP has a lot of potential. In future research, the improved version in Appendix F should be tested in clinical practice to further enhance the usefulness of the CSP. Further, we recommend to add items on patients’ belief in the treatment rationale, motivation for treatment and social support to the CSP and study whether this would enhance its predictability.