Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 137, Issue 1-3, Pages 106-112Publisher
ELSEVIER
DOI: 10.1016/j.jad.2011.12.008
Keywords
Anxiety; Depression; Comorbidity
Categories
Funding
- Netherlands Organisation for Health Research and Development (Zon-MW) [10-000-1002]
- VU University Medical Center
- GGZinGeest
- Arkin
- Leiden University Medical Center
- GGZ Rivierduinen
- University Medical Center Groningen
- Lends
- GGZ Friesland
- GGZ Drenthe
- IQ Healthcare
- Netherlands Institute for Health Services Research (NIVEL)
- Netherlands Institute of Mental Health and Addiction (Trimbos)
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Background: To study the clinical relevance of type of comorbidity and number of comorbid disorders in anxiety disorders. Four groups were compared according to sociodemographic-, vulnerability- and clinical factors: single anxiety disorder, anxiety-anxiety comorbidity, anxiety-depressive comorbidity and double comorbidity (i.e. anxiety and depressive comorbidity). Methods: Data were obtained from the Netherlands Study of Anxiety and Depression (NESDA). A sample of 1004 participants with a current anxiety disorder was evaluated. Results: As compared with single anxiety, anxiety-anxiety comorbidity was associated with higher severity, greater chronicity and more treatment. Anxiety-anxiety comorbidity was associated with an earlier age of onset and a more chronic course compared with anxiety-depressive comorbidity, while anxiety-depressive comorbidity was associated with more severe symptoms and more impaired functioning than anxiety-anxiety comorbidity. Double comorbidity was associated with higher severity, greater chronicity, more treatment and increased disability. Sociodemographic and vulnerability factors were comparable among the four groups. Limitations A prospective design would be more appropriate to study the outcome. In this study no distinction was made between whether depression or anxiety disorder preceded the current anxiety disorder. Conclusions: It is clinical relevant to diagnose and treat comorbidity among anxiety disorders as it is associated with higher severity and more chronicity. Whereas anxiety-anxiety comorbidity has an earlier age of onset and a more chronic course, anxiety-depressive comorbidity leads to more treatment and impaired functioning. Double comorbidity leads to even more severity, chronicity and impairment functioning compared with both anxiety-anxiety and anxiety-depressive comorbidity. (C) 2011 Elsevier B.V. All rights reserved.
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