Abstract
Aim of this study is to examine the effect of depressive comorbidity in 108 children and adolescents with Generalized Anxiety Disorder (GAD). Fifty-five patients with GAD and depression were compared with 53 patients with GAD without depression. Age, gender and socioeconomic status did not differentiate the groups. Patients with comorbid depression had significantly more anxiety symptoms than patients without depression. Clinical presentation of GAD and pattern of comorbidity was similar in the two groups. Subjects with comorbid depression showed a more severe functional impairment, assessed with C-GAS. Data are discussed in the light of conceptualizations about the relationship between anxiety and depression.
Similar content being viewed by others
References
American Psychiatric Association: Diagnostic and Statistical Manual for Mental Disorders. Ed. 4th. Washington, DC: American Psychiatric Association, 1994.
Di Nardo PA, Moras K, Barlow DH, Rapee RM, Brown TA: Reliability of DSM-III-R anxiety disorder categories using the Anxiety Disorders Interview Schedule-Revised (ADIS-R). Arch Gen Psychiatry 50: 251-256, 1993.
Barlow DH: Anxiety and his disorders: The nature and treatment of anxiety and panic. New York: Guilford, 1988.
Wittchen HU, Zhao S, Kessler RC, Eaves WW: DSM-III-R generalized anxiety disorder in a National Comorbidity Survey. Arch Gen Psychiatry 51: 355-364, 1994.
Robins LN, Regier DA (Eds): Psychiatric disorders in America: The Epidemiologic Catchment Area Study. New York: The Free Press, 1991, pp. 180-203.
Hoen-Sarlic R, Hazlett RL, McLeod DR: Generalized anxiety disorder with early and late onset of anxiety symptoms. Compr Psychiatry 34: 291-298, 1993.
Blazer DG, Hughes D, George LK: Stressful life events and the onset of the generalized anxiety disorder syndrome. Am J Psychiatry 144: 1178-1183, 1987.
American Psychiatric Association: Diagnostic and Statistical Manual for Mental Disorders. Ed. 3rd Rev. Washington, DC: American Psychiatric Association, 1987.
Klein RG, Tancer NK, Werry JS: Anxiety disorders of childhood or adolescence. In: Widiger TA, Frances AJ, Pincus HA, Ross R (eds): DSM-IV sourcebook. Vol. 3. Washington, DC: American Psichiatric Association, 1997, pp. 221-239.
Anderson JC, Williams S, McGee R, Silva PA: DSM III disorders in preadolescents children: prevalence in a large sample from the general population. Arch Gen Psychiatry 44: 69-76, 1987.
Costello EJ: Child psychiatric disorders and their correlates: A primary care pediatric sample. J Am Acad Child Adolesc Psychiatry 28: 851-855 1987.
Brawman-Mintzer O, Lydiard RB: Generalized anxiety disorder: Issues in epidemiology. J Clin Psychiatry 57(Suppl 7): 3-8, 1996.
Brawman-Mintzer O, Lydiard RB, Emmanuel N, Payeur R, Johnson M, Roberts J: Psychiatric comorbidity in patients with generalized anxiety disorder. Am J Psychiatry 150: 1216-1218, 1993.
Masi G, Mucci M, Favilla L, Romano R, Poli P: Symptomatology and comorbidity of generalized anxiety disorder in children and adolescents. Comprehens Psychiatry 40: 210-215, 1999.
Blazer D, Swartz M, Woodbury M: Depressive symptoms and depressive diagnoses in a community population: Use of a new procedure for the analysis of psychiatric classification. Arch Gen Psychiatry 45: 1078-1084, 1988.
Angst J: Comorbidity of anxiety, phobia, compulsion and depression. Int Clin Psychopharmacol 1993; 8(suppl 1): 21-25.
Masi G, Favilla L, Mucci M, Romano R, Poli P: Depressive symptoms in children and adolescents with dysthymic disorder. Psychopathology, in press.
Breslau N, Davis GC: DSM III generalized anxiety disorder: an empirical investigation of more stringent criteria. Psychiatry Res 14: 231-238, 1985.
Liebowitz RM, Hollander E, Schneier F, Campeas R, Fallon B, Welkowitz L, Cloitre M, Davies S: Anxiety and depression: Discrete diagnostic entities? J Clin Psychopharmacol 10(Suppl 3): 61S-66S, 1990.
Reich W, Shayka JI, Taibleson C: Diagnostic Interview for Children and Adolescents, Revised. Division of Child Psychiatry, Washington University, St Louis, MO, 1991
Herjanic B, Reich W: Development of a structured psychiatric interview for children: Agreement between parents on individual symptoms. J Abnorm Child Psychol 10: 307-324, 1982.
Welner Z, Reich W, Herjanic B, Jung KG, Amado H: Reliability, validity and parent-child agreement studies of the Diagnostic Interview for Children and Adolescents (DICA). J Am Acad Child Adolesc Psychiatry 26: 649-653, 1987.
Boyle M, Offord DR, Racine Y, Sanford M, Szatmari P, Fleming JE, Price-Munn N: Evaluation of the Diagnostic Interview for Children and Adolescents for use in general population samples. J Abn Child Psychol 21: 663-681, 1993.
Ezpeleta L, de la Osa N, Doménech JM, Navarro JB, Losilla JM: Diagnostic agreement between clinicians and the Diagnostic Interview for Children and Adolescents—DICA-R—in an outpatient sample. J Child Psychol Psychiatry 38: 431-440, 1997.
Kovacs M, Feinberg TL, Crouse-Novak M, Paulaskas SL, Finkelstein R: Depressive disorders in hildhood. I. A longitudinal prospective study of characteristics and recovery. Arch Gen Psychiatry 41: 229-237, 1984.
Kovacs M, Akiskal HS, Gatsonis C, Parrone PL: Childhood-onset dysthymic disorder. Clinical features and prospective naturalistic outcome. Arch Gen Psychiatry 51: 365-374, 1994.
Shaffer D, Gould M, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S: Children's Global Assessment Scale (CGAS). Arch Gen Psychiatry 40:1228-1231, 1983.
Green B, Shirk S Hanze D Wanstrath J: The Children's Global Assessment Scale in clinical practice: An empirical evaluation. J Am Acad Child Adolesc Psychiatry 33: 1158-1164, 1994.
Rey JM, Starling J, Wever C, Dossetor DR, Plapp JM: Inter-rater reliability of Global Assessment of Functioning in a clinical setting. J Child Psychol Psychiatry 36: 787-792, 1995.
Kovacs M, Gatsonis C, Paulaskas SL, Richards C: Depressive disorders in childhood. IV. A longitudinal study of comorbidity with and risk for anxiety disorder. Arch Gen Psychiatry 46: 776-782, 1989.
Mitchell J, McCauley E, Burke PM, Moss SJ: Phenomenology of depression in children and adolescents. J Am Acad Child Adolesc Psychiatry 27: 12-20, 1988.
Strauss CC, Last CG, Hersen M, Kazdin AE: Association between anxiety and depression in children and adolescents with anxiety disorder. J Abnorm Child Psychol 16:57-68, 1988.
Bernstein GA: Comorbidity and severity of anxiety and depressive disorders in a clinic sample. J Am Acad Child Adolesc Psychiatry 1991; 30: 43-50.
McGee R, Feehan M, Williams S, Partridge F, Silva PA, Kelly J: DSM III disorders in a large sample of adolescents. J Am Acad Child Adolesc Psychiatry 29: 611-619, 1990.
Strauss CC, Lease CA, Last CG, Francis G: Overanxious disorder: Examination of developmental difference. J Abn Child Psychol 16: 433-443, 1988.
Bell-Dolan DJ, Last CG, Strauss CC: Symptoms of anxiety disorders in normal children. J Am Acad Child Adolesc Psychiatry 29: 759-765, 1990.
Muris P, Meesters C, Merckelbach H, Sermon A, Zwakhalen S: Worry in normal children. J Am Acad Child Adolesc Psychiatry 37:703-710, 1998.
Hetch H, von Zerssen D, Krieg C, Possl J, Wittchen HU. Anxiety and depression: comorbidity, psychopathology and social functioning. Comprehens Psychiatry 30: 420-433, 1989.
Nutt D. Management of patients with depression associated with anxiety symptoms. J Clin Psychiatry 58(Suppl 8): 11-16, 1997.
Bird HR, Gould MS, Stagherzza BM: Pattern of diagnostic comorbidity in a community sample of children aged 9 through 16 years. J Am Acad Child Adolesc Psychiatry 32: 361-368, 1993.
Kendall PC, Kortlander E, Chansky TE, Brady EU. Comorbidity of anxiety and depression in youth: treatment implications. J Consult Clin Psychol 60: 869-880, 1992.
Kendler KS: Major depression and generalized anxiety disorder. Same genes, (partly) different environments—revisited. Br J Psychiatry (Suppl 30): 68-75, 1996.
Akiskal HS: Dysthymia: clinical and external validity. Acta Psychiatr Scand 89(suppl 383): 19-23, 1994.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Masi, G., Favilla, L., Mucci, M. et al. Depressive Comorbidity in Children and Adolescents with Generalized Anxiety Disorder. Child Psychiatry Hum Dev 30, 205–215 (2000). https://doi.org/10.1023/A:1021351722364
Issue Date:
DOI: https://doi.org/10.1023/A:1021351722364