Clinical relevance of comorbidity in anxiety disorders: A report from the Netherlands Study of Depression and Anxiety (NESDA)

Mieke Klein Hofmeijer-Sevink*, Neeltje M. Batelaan, Harold J. G. M. van Megen, Brenda W. Penninx, Danielle C. Cath, Marcel A. van den Hout, Anton J. L. M. van Balkom

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    109 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)106-112
    Number of pages7
    JournalJournal of Affective Disorders
    Volume137
    Issue number1-3
    DOIs
    Publication statusPublished - Mar-2012

    Keywords

    • Anxiety
    • Depression
    • Comorbidity
    • PSYCHIATRIC-DISORDERS
    • THREATENING EXPERIENCES
    • PSYCHOMETRIC PROPERTIES
    • MOOD DISORDERS
    • INVENTORY
    • LIFE
    • RELIABILITY
    • NEUROTICISM
    • VALIDITY
    • PSYCHOPATHOLOGY

    Cite this