Hostname: page-component-5c6d5d7d68-txr5j Total loading time: 0 Render date: 2024-08-16T09:37:40.321Z Has data issue: false hasContentIssue false
  • English
  • Français

Comorbidity and the General Neurotic Syndrome

Published online by Cambridge University Press:  06 August 2018

Gavin Andrews
Gavin Andrews*
Affiliation:
School of Psychiatry, University of New South Wales at St Vincent's Hospital, Sydney, Australia
*
Professor G. Andrews, Clinical Research Unit for Anxiety Disorders, 299 Forbes Street, Darlinghurst, NSW 2010, Australia
Get access Rights & Permissions [Opens in a new window]

Abstract

The observation that people with an anxiety or depressive disorder also have an increased likelihood of having had other anxiety or depressive disorders in their lifetime means either that the separate causes of these disorders have aggregated, much more than chance would allow, or that some general vulnerability factor has made them liable to each and all of the disorders they report. In this paper, three separate sources of information – symptoms occurring in the general population, disorders occurring in the general population, and disorders occurring in patients who have sought treatment – are reviewed. In all three domains of information, a general vulnerability factor, associated with personality trait measures of high trait anxiety and poor coping, emerges as a principal cause of these symptoms or disorders, and accounts for the majority of the variation in the comorbidity of symptoms or disorders. This vulnerability factor is shown to be under substantial genetic control. Nevertheless it can be modified by appropriate treatment, and prevention strategies exist to reduce the incidence of the anxiety and depressive disorders.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 168 , Issue S30: Comorbidity of Mood Disorders , June 1996 , pp. 76 - 84
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, G. (1991) Anxiety, personality and anxiety disorders. International Review of Psychiatry, 3, 293–302.Google Scholar
Andrews, G., Kiloh, L. G. & Kehoe, L. (1978) Asthenic personality, myth or reality. Australian and New Zealand Journal of Psychiatry, 12, 95–98.Google Scholar
Andrews, G. & Moran, C. (1988) Exposure treatment of agoraphobia with panic attacks: are drugs essential? In Panic and Phobias II. Treatments and Variables Affecting Course and Outcome (eds Hand, I. & Wittchen, H.-U.), pp. 89–99. Heidelberg: Springer-Verlag.Google Scholar
Andrews, G., Neilson, M. D., Hunt, C., et al (1990a) Diagnosis, personality and the long-term outcome of depression. British Journal of Psychiatry, 157, 13–18.Google Scholar
Andrews, G., Stewart, G. W., Allen, R., et al (1990b) The genetics of six neurotic disorders: a twin study. Journal of Affective Disorders, 19, 23–29.Google Scholar
Andrews, G., Stewart, G. W., Morris-Yates, A., et al (1990c) Evidence for a general neurotic syndrome. British Journal of Psychiatry, 157, 6–12.Google Scholar
Andrews, G., Singh, M. & Bond, M. (1993a) The Defense Style Questionnaire. Journal of Nervous and Mental Disease, 181, 246–256.CrossRefGoogle ScholarPubMed
Andrews, G., Page, A. C. & Neilson, M. D. (1993b) Sending your teenagers away: controlled stress decreases neurotic vulnerability. Archives of General Psychiatry, 50, 585–589.Google Scholar
Bolger, N. (1990) Coping as a personality process: a prospective study. Journal of Personality and Social Psychology, 59, 525–537.CrossRefGoogle ScholarPubMed
Craig, A., Franklin, J. & Andrews, G. (1984) A scale to measure locus of control of behaviour. British Journal of Medical Psychology, 57, 173–180.Google Scholar
Crino, R. D. & Andrews, G. (1996) Obsessive compulsive disorder and Axis I co-morbidity. Journal of Anxiety Disorders, 10, 37–46.Google Scholar
Duncan-Jones, P. (1987) Modelling the aetiology of neurosis: long-term and short-term factors. In Psychiatric Epidemiology: Progress and Prospects (ed. Cooper, B.), pp. 178–191. London: Croom Helm.Google Scholar
Eysenck, H. J. & Eysenck, S. B. G. (1975) Personality Questionnaire (Junior and Adult). Essex: Hodder & Stoughton.Google Scholar
Fergusson, D., Andrews, G., Morris-Yates, A., et al (1992) Vulnerability and Resilience in Neurosis. Working paper No. 1. Sydney, Australia: Clinical Research Unit for Anxiety Disorders.Google Scholar
Hunt, C. & Andrews, G. (1995) Comorbidity of anxiety disorders: life chart approach. Journal of Psychiatric Research, 29, 467–480.Google Scholar
Jardine, R., Martin, N. G. & Henderson, A. S. (1984) Genetic covariation between neuroticism and the symptoms of anxiety and depression. Genetic Epidemiology, 1, 89–107.Google Scholar
Jorm, A. F. (1989) Modifiability of trait anxiety and neuroticism: a meta-analysis of the literature. Australian and New Zealand Journal of Psychiatry, 23, 21–29.Google Scholar
Kendall, P. C., Howard, B. L. & Epps, J. (1988) The anxious child: cognitive–behavioural treatment strategies. Behaviour Modification, 12, 281–310.Google Scholar
Kendler, K. S., Heath, A., Martin, N. G., et al (1986) Symptoms of anxiety and depression in a volunteer twin population. Archives of General Psychiatry, 43, 213–221.CrossRefGoogle Scholar
Kendler, K. S., Heath, A., Martin, N. G., et al (1987) Symptoms of anxiety and symptoms of depression. Same genes, different environments? Archives of General Psychiatry, 44, 451–457.Google Scholar
Kendler, K. S., Kessler, R. C., Heath, A. C., et al (1991) Coping: a genetic epidemiological investigation. Psychological Medicine, 21, 337–346.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., et al (1992a) Generalized anxiety disorder in women. A population-based twin study. Archives of General Psychiatry, 49, 267–272.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., et al (1992b) Major depression and generalized anxiety disorder. Same genes, (partly) different environments? Archives of General Psychiatry, 49, 716–722.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., et al (1992c) The genetic epidemiology of phobias in women. The interrelationship of agoraphobia, social phobia, situational phobia and simple phobia. Archives of General Psychiatry, 49, 273–281.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., et al (1993a) Major depression and phobias: the genetic environmental sources of comorbidity. Psychological Medicine, 23, 361–371.CrossRefGoogle ScholarPubMed
Kendler, K. S., Neale, M. C., Kessler, R. C., et al (1993b) Panic disorder in women: a population-based twin study. Psychological Medicine, 23, 397–406.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., et al (1993c) A longitudinal twin study of 1-year prevalence of major depression in women. Archives of General Psychiatry, 50, 843–852.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., et al (1993d) A longitudinal twin study of personality and major depression in women. Archives of General Psychiatry, 50, 853–862.Google Scholar
Kiloh, L. G., Andrews, G., Neilson, M., et al (1972) The relationship of the syndromes called endogenous and neurotic depression. British Journal of Psychiatry, 121, 183–196.Google Scholar
Martin, N. G., Jardine, R., Andrews, G., et al (1988) Anxiety disorders: are there genetic factors specific to panic? Acta Psychiatrica Scandinavica, 77, 698–706.CrossRefGoogle ScholarPubMed
Moran, C. & Andrews, G. (1985) The familial occurrence of agoraphobia. British Journal of Psychiatry, 146, 262–267.CrossRefGoogle ScholarPubMed
Ormel, J. (1983) Neuroticism and well-being inventories: measuring traits or states? Psychological Medicine, 13, 165–176.Google Scholar
Ormel, J. & Wohlfarth, T. (1991) How neuroticism, long-term difficulties, and life situation change influence psychological distress: a longitudinal model. Journal of Personality and Social Psychology, 60, 744–755.Google Scholar
Poulton, R. & Andrews, G. (1992) Personality as a cause of adverse life events. Acta Psychiatrica Scandinavica, 85, 35–38.Google Scholar
Robertson, H. A., Martin, I. L. & Candy, J. M. (1978) Differences in benzodiazepine receptor binding in Maudsley reactive and Maudsley nonreactive rats. European Journal of Pharmacology, 50, 455–457.Google Scholar
Torgersen, S. (1983) Genetics of neurosis. The effects of sampling variation upon the twin concordance ratio. British Journal of Psychiatry, 142, 126–132.Google Scholar
World Health Organization (1993) CIDI-Auto Version 1.0: Administrator's Guide and Reference. Sydney: Training and Reference Centre for WHO–CIDI.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.