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Comorbidity and Boundaries of Affective Disorders with Anxiety Disorders and Substance Misuse: Results of an International Task Force

Published online by Cambridge University Press:  06 August 2018

K. R. Merikangas ,
J. Angst ,
W. Eaton ,
G. Canino ,
M. Rubio-Stipec ,
H. Wacker ,
H.-U. Wittchen ,
L. Andrade ,
C. Essau  and
A. Whitaker
...Show all authors
K. R. Merikangas*
Affiliation:
Yale University School of Medicine
J. Angst
Affiliation:
University of Zurich, Lenggstrasse 31, CH-8029, Zurich, Switzerland
W. Eaton
Affiliation:
Johns Hopkins University, 624 North Broadway, Baltimore, MD, USA, 21205-1999
G. Canino
Affiliation:
University of Puerto Rico, Centro Medico, STEA-928, Rio Piedras, PR, USA 00935-0001
M. Rubio-Stipec
Affiliation:
University of Puerto Rico, Centro Medico, STEA-928, Rio Piedras, PR, USA 00935-0001
H. Wacker
Affiliation:
Psychiatrische Universitatsklinik, Petersgraben 4, CH-4031 Basel, Switzerland
H.-U. Wittchen
Affiliation:
Max Planck Institute of Psychiatry, Kraepelinstrasse 2 & 10, D-800, Munich 40, Germany
L. Andrade
Affiliation:
Instituto de Psiquiatria, Hospital de Clinicas, Sao Paulo SP, Brazil, Caixa Postal 8091
C. Essau
Affiliation:
Kinderambulanz, Universität Bremen, Grazer Strasse 2, 28359 Bremen, Germany
A. Whitaker
Affiliation:
Yale University School of Medicine
H. Kraemer
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA 94305
L. N. Robins
Affiliation:
Washington University School of Medicine, 4940 Children's Place, St. Louis, MO, USA 63110-1093
D. J. Kupfer
Affiliation:
University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, USA 15213
*
Dr K. R. Merikangas, Yale University School of Medicine, Genetic Epidemiology Research Unit, 40 Temple Street, Suite 7B, New Haven, Connecticut 06510-3223, USA
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Abstract

Associations between affective disorders, anxiety disorders, and substance use disorders were examined in epidemiological studies conducted in Germany, Switzerland, Puerto Rico, and the mainland US. There was a remarkable degree of similarity across studies in the magnitude and type of specific disorders associated with the affective disorders. Comorbidity with affective disorders was greater for the anxiety disorders than for substance misuse. Panic disorder was the subtype of anxiety that was most highly comorbid with depression. Social phobia was the specific phobic type with the strongest association with the affective disorders. The magnitude of associations between substance misuse and affective disorders generally was quite low and less consistent across sites. No major differences were found in the patterns of comorbidity by gender or age group, affective subtype or prevalence period. The onset of anxiety disorders generally preceded that of depression, whereas alcohol misuse was equally likely to pre- or post-date the onset of affective disorders. Finally, comorbidity was associated with an elevation in treatment ratesacross all sites, confirming Berkson's paradox on an international level.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 168 , Issue S30: Comorbidity of Mood Disorders , June 1996 , pp. 58 - 67
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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