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Randomized Controlled Trial
. 2012 Dec;29(12):1065-71.
doi: 10.1002/da.22026. Epub 2012 Nov 26.

Diagnostic overlap of generalized anxiety disorder and major depressive disorder in a primary care sample

Tomislav D Zbozinek  1 , Raphael D Rose, Kate B Wolitzky-Taylor, Cathy Sherbourne, Greer Sullivan, Murray B Stein, Peter P Roy-Byrne, Michelle G Craske
Affiliations
Randomized Controlled Trial

Diagnostic overlap of generalized anxiety disorder and major depressive disorder in a primary care sample

Tomislav D Zbozinek et al. Depress Anxiety. 2012 Dec.

Abstract

Background: Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are highly comorbid. A possible explanation is that they share four symptoms according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision (DSM-IV-TR). The present study addressed the symptom overlap of people meeting DSM-IV-TR diagnostic criteria for GAD, MDD, or both to investigate whether comorbidity might be explained by overlapping diagnostic criteria.

Methods: Participants (N = 1,218) were enrolled in the Coordinated Anxiety Learning and Management study (a randomized effectiveness clinical trial in primary care). Hypotheses were (1) the comorbid GAD/MDD group endorses the overlapping symptoms more than the nonoverlapping symptoms, and (2) the comorbid GAD/MDD group endorses the overlapping symptoms more than GAD only or MDD only groups, whereas differences would not occur for nonoverlapping symptoms.

Results: The overlapping GAD/MDD symptoms were endorsed more by the comorbid group than the MDD group but not the GAD group when covarying for total symptom endorsement. Similarly, the comorbid group endorsed the overlapping symptoms more than the nonoverlapping symptoms and did not endorse the nonoverlapping symptoms more than the GAD or MDD groups when covarying for total symptom endorsement.

Conclusions: The results suggest that comorbidity of GAD and MDD is strongly influenced by diagnostic overlap. Results are discussed in terms of errors of diagnostic criteria, as well as models of shared psychopathology that account for diagnostic criteria overlap.

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References

    1. Sunderland M, Mewton L, Slade T, Baillie AJ. Investigating differential symptom profiles in major depressive episode with and without generalized anxiety disorder: true comorbidity or symptom similarity? Psychol Med. 2010;40:1113–1123. - PubMed
    1. Watson D. Rethinking the mood and anxiety disorders: a quantitative hierarchical model for DSM-V. J Abnorm Psychol. 2005;114:522–536. - PubMed
    1. Brown TA, Marten PA, Barlow DH. Discriminant validity of the symptoms constituting the DSM-III-R and DSM-IV associated symptom criterion of generalized anxiety disorder. J Anxiety Disord. 1995;9:317–328.
    1. Goisman RM, Goldenberg I, Vasile RG, Keller MB. Comorbidity of anxiety disorders in a multicenter anxiety study. Compr Psychiatry. 1995;36:303–311. - PubMed
    1. Newman M, Przeworski A, Fisher A, Borkovec T. Diagnostic comorbidity in adults with generalized anxiety disorder: impact of comorbidity on psychotherapy outcome and impact of psychotherapy on comorbid diagnoses. Behav Ther. 2010;41:59–72. - PMC - PubMed

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