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Depressive Disorders in ChildhoodIV. A Longitudinal Study of Comorbidity With and Risk for Anxiety Disorders
Maria Kovacs, PhD;
Constantine Gatsonis, PhD;
Stana L. Paulauskas, PhD;
Cheryl Richards
Arch Gen Psychiatry. 1989;46(9):776-782.
Abstract
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• As part of a longitudinal nosologic study of major depressive disorder (MDD), dysthymic disorder (DD), and adjustment disorder with depressed mood (ADDM) in a school-age cohort, we examined the prevalence and clinical consequences of comorbid anxiety disorders. We also estimated the risk of a first anxiety disorder and examined its predictors. Of 104 cases, 41% had anxiety disorders in conjunction with their index depression, which was more likely with MDD and DD than with ADDM. The age-corrected risk of a first anxiety disorder was 0.47 up to age 18 years. Separation-anxiety disorder was the most frequent disgnosis of anxiety, followed by overanxious disorder of childhood. Among the MDD cases with comorbidity, the anxiety disorder preceded the depression about two thirds of the time and often persisted after the depression remitted. The effect of comorbid anxiety disorder on the length of index MDD depended on the presence of other clinical features, but it did not seem to affect the risk of subsequent MDD or the course of DD or ADDM. Concurrent maternal psychopathology and poor physical health increased the risk of anxiety disorder in the children, but a history of prior separation from parental figures did not seem to have an effect.
Author Affiliations
From the Department of Psychiatry, University of Pittsburgh School of Medicine and the Western Psychiatric Institute and Clinic, Pittsburgh, Pa (Dr Kovacs and Ms Richards); the Department of Health Care Policy, Harvard Medical School, Boston, Mass (Dr Gatsonis); and the Department of Psychiatry, Ohio State University, Columbus (Dr Paulauskas).
Footnotes
Accepted for publication January 10, 1989.
Reprint requests to Western Psychiatric Institute and Clinic, 3811 O'Hara St, Pittsburgh, PA 15213 (Dr Kovacs).
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