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Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder.
Arch Gen Psychiatry. 2010 Jan; 67(1):47-57.AG

Abstract

CONTEXT

Controversy surrounds the diagnostic categorization of generalized anxiety disorder (GAD).

OBJECTIVES

To examine the incidence, comorbidity, and risk patterns for anxiety and depressive disorders and to test whether developmental features of GAD more strongly support a view of this condition as a depressive as opposed to an anxiety disorder.

DESIGN

Face-to-face, 10-year prospective longitudinal and family study with as many as 4 assessment waves. The DSM-IV Munich Composite International Diagnostic Interview was administered by clinically trained interviewers.

SETTING

Munich, Germany.

PARTICIPANTS

A community sample of 3021 individuals aged 14 to 24 years at baseline and 21 to 34 years at last follow-up.

MAIN OUTCOME MEASURES

Cumulative incidence of GAD, other anxiety disorders (specific phobias, social phobia, agoraphobia, and panic disorder), and depressive disorders (major depressive disorder, and dysthymia).

RESULTS

Longitudinal associations between GAD and depressive disorders are not stronger than those between GAD and anxiety disorders or between other anxiety and depressive disorders. Survival analyses reveal that the factors associated with GAD overlap more strongly with those specific to anxiety disorders than those specific to depressive disorders. In addition, GAD differs from anxiety and depressive disorders with regard to family climate and personality profiles.

CONCLUSIONS

Anxiety and depressive disorders appear to differ with regard to risk constellations and temporal longitudinal patterns, and GAD is a heterogeneous disorder that is, overall, more closely related to other anxiety disorders than to depressive disorders. More work is needed to elucidate the potentially unique aspects of pathways and mechanisms involved in the etiopathogenesis of GAD. Grouping GAD with depressive disorders, as suggested by cross-sectional features and diagnostic comorbidity patterns, minimizes the importance of longitudinal data on risk factors and symptom trajectories.

Authors+Show Affiliations

Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer St 46, 01187 Dresden, Germany. Katja.Beesdo@tu-dresden.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20048222

Citation

Beesdo, Katja, et al. "Incidence and Risk Patterns of Anxiety and Depressive Disorders and Categorization of Generalized Anxiety Disorder." Archives of General Psychiatry, vol. 67, no. 1, 2010, pp. 47-57.
Beesdo K, Pine DS, Lieb R, et al. Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder. Arch Gen Psychiatry. 2010;67(1):47-57.
Beesdo, K., Pine, D. S., Lieb, R., & Wittchen, H. U. (2010). Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder. Archives of General Psychiatry, 67(1), 47-57. https://doi.org/10.1001/archgenpsychiatry.2009.177
Beesdo K, et al. Incidence and Risk Patterns of Anxiety and Depressive Disorders and Categorization of Generalized Anxiety Disorder. Arch Gen Psychiatry. 2010;67(1):47-57. PubMed PMID: 20048222.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder. AU - Beesdo,Katja, AU - Pine,Daniel S, AU - Lieb,Roselind, AU - Wittchen,Hans-Ulrich, PY - 2010/1/6/entrez PY - 2010/1/6/pubmed PY - 2010/1/21/medline SP - 47 EP - 57 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 67 IS - 1 N2 - CONTEXT: Controversy surrounds the diagnostic categorization of generalized anxiety disorder (GAD). OBJECTIVES: To examine the incidence, comorbidity, and risk patterns for anxiety and depressive disorders and to test whether developmental features of GAD more strongly support a view of this condition as a depressive as opposed to an anxiety disorder. DESIGN: Face-to-face, 10-year prospective longitudinal and family study with as many as 4 assessment waves. The DSM-IV Munich Composite International Diagnostic Interview was administered by clinically trained interviewers. SETTING: Munich, Germany. PARTICIPANTS: A community sample of 3021 individuals aged 14 to 24 years at baseline and 21 to 34 years at last follow-up. MAIN OUTCOME MEASURES: Cumulative incidence of GAD, other anxiety disorders (specific phobias, social phobia, agoraphobia, and panic disorder), and depressive disorders (major depressive disorder, and dysthymia). RESULTS: Longitudinal associations between GAD and depressive disorders are not stronger than those between GAD and anxiety disorders or between other anxiety and depressive disorders. Survival analyses reveal that the factors associated with GAD overlap more strongly with those specific to anxiety disorders than those specific to depressive disorders. In addition, GAD differs from anxiety and depressive disorders with regard to family climate and personality profiles. CONCLUSIONS: Anxiety and depressive disorders appear to differ with regard to risk constellations and temporal longitudinal patterns, and GAD is a heterogeneous disorder that is, overall, more closely related to other anxiety disorders than to depressive disorders. More work is needed to elucidate the potentially unique aspects of pathways and mechanisms involved in the etiopathogenesis of GAD. Grouping GAD with depressive disorders, as suggested by cross-sectional features and diagnostic comorbidity patterns, minimizes the importance of longitudinal data on risk factors and symptom trajectories. SN - 1538-3636 UR - https://www.unboundmedicine.com/medline/citation/20048222/Incidence_and_risk_patterns_of_anxiety_and_depressive_disorders_and_categorization_of_generalized_anxiety_disorder_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archgenpsychiatry.2009.177 DB - PRIME DP - Unbound Medicine ER -