Depressive episodes–evidence for a causal role of primary anxiety disorders?

European Psychiatry - Tập 18 Số 8 - Trang 384-393 - 2003
Hans‐Ulrich Wïttchen1,2, Katja Beesdo‐Baum1, Antje Bittner1, Renée D. Goodwin3
1Institute of Clinical Psychology and Psychotherapy, Dresden University of Technology, Chemnitzerstrasse 46, 01187Dresden, Germany
2Max Planck Institute of Psychiatry, Munich, Germany
3Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA

Tóm tắt

Abstract

Anxiety and depressive disorders are common mental disorders in general population, imposing tremendous burden on both affected persons and society. Moreover, comorbidity between anxiety and depressive conditions is high, leading to substantial disability and functional impairment. Findings consistently suggest that anxiety disorders are primary to depression in the majority of comorbid cases. Yet, the question of whether anxiety disorders are risk factors for depression, and potentially even causal risk factors for the first onset of depression, remains unresolved. Recent results have shown that anxiety disorders increase the risk for subsequent depression, and also affect the course of depression, resulting in a poorer prognosis. Further, some results suggest a dose–response-relationship in revealing that a higher number of anxiety disorders and more severe impairment associated with anxiety disorders additionally increase the risk for subsequent depression. The goal of this paper is to review recent literature, summarize implications of previous findings, and suggest directions for future research regarding preventive and intervention strategies.

Từ khóa


Tài liệu tham khảo

10.1001/archpsyc.55.9.771

Breier, 1985, The diagnostic validity of anxiety disorders and their relationship to depressive illness, Am J Psychiatry, 142, 787, 10.1176/ajp.142.7.787

10.1001/archpsyc.1997.01830160021003

Robins, 1991, Psychiatric disorders in Amerika: the Epide-miologic Catchment Area Study

Eaton, 1991, Psychiatric disorders in America The epidemiologic catchment area study, 155

10.1375/bech.18.2.92

10.1192/S0007125000298425

Wittchen, 2001, Generalized anxiety disorder: nature and course, J Clin Psychiatry, 62, 15

10.1037/0021-843X.102.1.133

10.1001/archpsyc.1996.01830020077009

10.1001/archpsyc.1997.01830160065009

10.1017/S0033291799008454

10.1001/archpsyc.1994.03950010008002

Kessler, 1997, Treatment strategies for patients with psychiatric comorbidity, 23

Wittchen, 2003, Natural course and burden of bipolar disorders, Int J Neuropharmacol, 6, 145

10.1001/archpsyc.1995.03950170048007

10.1001/archpsyc.1992.01820090044008

Jacobi, Prevalence, comorbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS), Psychol Med

10.1016/S0193-953X(05)70254-9

10.1002/mpr.128

10.1192/S0007125000298358

Gillham, 1999, Prevention of depressive symptoms in school children, A research update: two-year follow-up. Psychol Sci, 6, 343

Essau, 1998, Häufigkeit Conradt J. Komor-bidität und psychosoziale Beeinträchtigung von Depressiven Störun-gen bei Jugendlichen: Ergebnisse der Bremer Jugendstudie, Z Klin Psychol Psychother, 46, 316

Essau, 1998, Häufigkeit und Komorbidität psychischer Störungen bei Jugendlichen: Ergebnisse der Bremer Jugendstudie, Z Klin Psychol Psychother, 46, 105

10.1017/S0033291799008375

Wittchen, 1999, Childhood onset of “adult” psychopathology, clinical and research advances, 259

10.1001/archpsyc.59.1.43

Kessler, 1999, Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys, Am J Psychiatry, 156, 1915, 10.1176/ajp.156.12.1915

10.1001/archpsyc.58.12.1127

10.1001/archpsyc.56.10.921

10.1192/S0007125000293483

Blazer, 1991, Psychiatric disorders in America: the epidemiologic catchment area study, 180

10.1097/00004850-200015060-00002

10.1001/archpsyc.1994.03950050015002

10.1002/da.1020

10.1001/archpsyc.56.10.929

10.1007/s004060050023

Stein, 2001, Social anxiety disorder and the risk of depression, A prospective community study of adolescents and young adults. Arch Gen Psychiatry, 58, 251

10.1016/S0010-440X(00)80018-8

10.1002/mpr.138

10.1017/S0033291702005482

10.1111/j.0065-1591.2000.acp29-03.x

10.1001/archpsyc.58.6.597

10.1007/s001270050098

10.1192/S0007125000293458

Wittchen, 2002, Generalized anxiety and depression in primary care: prevalence, recognition and management, J Clin Psychiatry, 63, 24

Schuster, Depressionen bei Jugendlichen und jungen Erwachsenen. Eine klinisch-epidemiologische Analyse. Stuttgart: Schattauer Verlag; 2001 Mit einem Geleitwort von Prof, Dr. Dipl.-Psych. Hans-Ulrich Wittchen

10.1037/0021-843X.107.2.216

Bittner, What characteristics of primary anxiety disorders predict subsequent major depression?, J Clin Psychiatry, submitted for publication

10.1192/S0007125000298383

Wittchen, 1991, Der Langzeitverlauf unbehandelter Angststörungen: Wie häufig sind Spontanremissionen? Verhaltensther, 1, 273

Kendler, 1996, Major depression and generalised anxiety disorder, Same genes, (partly) different environments-revisited. Br J Psychiatry, 168, 68

10.1001/archpsyc.1990.01810180011002

Wittchen, 2003, Anxiety disorders, 25

Massion, 1993, Quality of life and psychiatric morbidity in panic disorder and generalized anxiety disorder, Am J Psychiatry, 150, 600, 10.1176/ajp.150.4.600

10.1097/00004850-200007001-00003

10.1017/S0033291797005928

10.1192/S0007125000298371

10.1176/appi.ajp.158.7.1146

Meyer, 2000, Lebenszeit-prävalenz psychischer Störungen in der erwachsenen Allgemeinbev-ölerung, Ergebnisse der TOCAS-Studie. Nervenarzt, 71, 535