 |
|
Depression and Generalized Anxiety DisorderCumulative and Sequential Comorbidity in a Birth Cohort Followed Prospectively to Age 32 Years
Terrie E. Moffitt, PhD;
HonaLee Harrington, BA;
Avshalom Caspi, PhD;
Julia Kim-Cohen, PhD;
David Goldberg, DM, FRCP;
Alice M. Gregory, PhD;
Richie Poulton, PhD
Arch Gen Psychiatry. 2007;64(6):651-660.
Context The close association between generalized anxiety disorder (GAD) and major depressive disorder (MDD) prompts questions about how to characterize this association in future diagnostic systems. Most information about GAD-MDD comorbidity comes from patient samples and retrospective surveys.
Objective To revisit the sequential and cumulative comorbidity between GAD and MDD using data from a prospective longitudinal cohort.
Design Prospective longitudinal cohort study.
Setting New Zealand.
Participants The representative 1972-1973 Dunedin birth cohort of 1037 members was followed up to age 32 years with 96% retention.
Main Outcome Measures Research diagnoses of anxiety and depression were made at ages 11, 13, 15, 18, 21, 26, and 32 years. Mental health services were reported on a life history calendar.
Results Sequentially, anxiety began before or concurrently in 37% of depression cases, but depression began before or concurrently in 32% of anxiety cases. Cumulatively, 72% of lifetime anxiety cases had a history of depression, but 48% of lifetime depression cases had anxiety. During adulthood, 12% of the cohort had comorbid GAD + MDD, of whom 66% had recurrent MDD, 47% had recurrent GAD, 64% reported using mental health services, 47% took psychiatric medication, 8% were hospitalized, and 11% attempted suicide. In this comorbid group, depression onset occurred first in one third of the participants, anxiety onset occurred first in one third, and depression and anxiety onset began concurrently in one third.
Conclusions Challenging the prevailing notion that generalized anxiety usually precedes depression and eventually develops into depression, these findings show that the reverse pattern occurs almost as often. The GAD-MDD relation is strong, suggesting that the disorders could be classified in 1 category of distress disorders. Their developmental relation seems more symmetrical than heretofore presumed, suggesting that MDD is not necessarily primary over GAD in diagnostic hierarchy. This prospective study suggests that the lifetime prevalence of GAD and MDD may be underestimated by retrospective surveys and that comorbid GAD + MDD constitutes a greater mental health burden than previously thought.
Author Affiliations: Institute of Psychiatry, King's College London, London, England (Drs Moffitt, Caspi, and Goldberg); Departments of Psychology and Neuroscience, and Psychiatry and Behavioral Sciences, and Institute for Genome Sciences and Policy, Duke University, Durham, NC (Drs Moffitt and Caspi); Department of Psychology, University of Wisconsin, Madison (Ms Harrington); Department of Psychology, Yale University, New Haven, Conn (Dr Kim-Cohen); Department of Psychology, Goldsmith's College, London (Dr Gregory); and Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand (Dr Poulton).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Business mergers and acquisitions and the risk of mental disorders: a population-based study
Wang et al.
Occup. Environ. Med. 2012;0:oemed-2011-100182v1-oemed-2011-100182.
ABSTRACT
| FULL TEXT
Chapter 3 Clinical features
Patterson et al.
OPL Generalized Anxiety Disorder 2011;1:med-9780199557837-chapter-med-9780199557837-chapter.
ABSTRACT
| FULL TEXT
The Effect of Exercise Training on Anxiety Symptoms Among Patients: A Systematic Review
Herring et al.
Arch Intern Med 2010;170:321-331.
ABSTRACT
| FULL TEXT
Incidence and Risk Patterns of Anxiety and Depressive Disorders and Categorization of Generalized Anxiety Disorder
Beesdo et al.
Arch Gen Psychiatry 2010;67:47-57.
ABSTRACT
| FULL TEXT
Adverse Childhood Experiences and Adult Risk Factors for Age-Related Disease: Depression, Inflammation, and Clustering of Metabolic Risk Markers
Danese et al.
Arch Pediatr Adolesc Med 2009;163:1135-1143.
ABSTRACT
| FULL TEXT
Predictive Value of Family History on Severity of Illness: The Case for Depression, Anxiety, Alcohol Dependence, and Drug Dependence
Milne et al.
Arch Gen Psychiatry 2009;66:738-747.
ABSTRACT
| FULL TEXT
Childhood and Adolescent Psychiatric Disorders as Predictors of Young Adult Disorders
Copeland et al.
Arch Gen Psychiatry 2009;66:764-772.
ABSTRACT
| FULL TEXT
Evaluation of a Structural Model of Objectification Theory and Eating Disorder Symptomatology Among European American and African American Undergraduate Women
Mitchell and Mazzeo
Psychology of Women Quarterly 2009;33:384-395.
ABSTRACT
| FULL TEXT
Common and Distinct Amygdala-Function Perturbations in Depressed vs Anxious Adolescents
Beesdo et al.
Arch Gen Psychiatry 2009;66:275-285.
ABSTRACT
| FULL TEXT
Stress and Anxiety in Schizophrenia and Depression: Glucocorticoids, Corticotropin-Releasing Hormone and Synapse Regression
Bennett Ao
Aust N Z J Psychiatry 2008;42:995-1002.
ABSTRACT
| FULL TEXT
Cognitive Ability in Early Adulthood and Risk of 5 Specific Psychiatric Disorders in Middle Age: The Vietnam Experience Study
Gale et al.
Arch Gen Psychiatry 2008;65:1410-1418.
ABSTRACT
| FULL TEXT
Comorbid Forms of Psychopathology: Key Patterns and Future Research Directions
Cerda et al.
Epidemiol Rev 2008;30:155-177.
ABSTRACT
| FULL TEXT
Anxiety Disorders no More?
Starcevic
Australas Psychiatry 2008;16:317-321.
ABSTRACT
| FULL TEXT
Elevated Inflammation Levels in Depressed Adults With a History of Childhood Maltreatment
Danese et al.
Arch Gen Psychiatry 2008;65:409-415.
ABSTRACT
| FULL TEXT
Maternal Symptoms of Stress, Depression, and Anxiety Are Related to Nonresponsive Feeding Styles in a Statewide Sample of WIC Participants
Hurley et al.
J. Nutr. 2008;138:799-805.
ABSTRACT
| FULL TEXT
From The Editor's Desk
Tyrer
Br. J. Psychiatry 2008;192:242-242.
FULL TEXT
The classification of depression: are we still confused?
Cole et al.
Br. J. Psychiatry 2008;192:83-85.
ABSTRACT
| FULL TEXT
Depression and Anxiety as Predictors of 2-Year Cardiac Events in Patients With Stable Coronary Artery Disease
Frasure-Smith and Lesperance
Arch Gen Psychiatry 2008;65:62-71.
ABSTRACT
| FULL TEXT
|
