Anxiety and depression: Comorbidity, psychopathology, and social functioning

Hecht, H.; Zerssen, D. von; Krieg, Christian; Pössl, Josef; Wittchen, Hans‐Ulrich

doi:10.1016/0010-440x(89)90008-4

Cited by 46 publications

(17 citation statements)

References 27 publications

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“…These results support previous data comparing psychosocial functioning in pure anxiety or depressive disorders 17, 41 and their comorbidity 42. With regard to specific anxiety disorders, we found that GAD and especially SP are more strongly associated with social dysfunction or higher impairment compared to PD and AP, which is in agreement with findings of several other studies 9, 34, 43.…”

Section: Discussionsupporting

confidence: 93%

“…When these disorders co‐occur, the chronicity and functional impairments rise substantially 16, 17, 18. Yet, even though social dysfunction is among the most pervasive and debilitating symptoms of affective psychopathology and tends to persist long after remission, a thorough examination of social functioning in clinically anxious or depressed patients, as well in those presenting comorbidity and those in remission, is currently lacking 19, 20, 21, 22.…”

Section: Introductionmentioning

confidence: 99%

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Social functioning in patients with depressive and anxiety disorders

Saris

Aghajani

Werff

et al. 2017

Acta Psychiatr Scand

150

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ObjectiveAdaptive social functioning is severely impeded in depressive and anxiety disorders, even after remission. However, a comprehensive overview is still lacking.MethodUsing data from the Netherlands Study of Depression and Anxiety (NESDA), behavioural (network size, social activities, social support) and affective (loneliness, affiliation, perceived social disability) indicators of social functioning were analyzed in patients with anxiety (N = 540), depressive (N = 393), comorbid anxiety and depressive disorders (‘comorbid’, N = 748), remitted participants (N = 621), and healthy control subjects (N = 650).ResultsAnalyses revealed an increasing trend of social dysfunction among patient groups, in patients with comorbid anxiety and depressive disorders, showing the most severe impairments, followed by depressed and anxious patients (P's < 0.001 for all social functioning indicators). Affective indicators showed the largest effect sizes (Cohen's d range from 0.13 to 1.76). We also found impairments in social functioning among remitted patients. Furthermore, perceived social disability among patients was predictive of still having a depressive and/or anxiety diagnosis 2 years later (P < 0.01).ConclusionsBehavioural but especially affective indicators of social functioning are impaired in patients with anxiety or depressive disorders and most in patients with comorbid disorders. After remission of affective psychopathology, residual impairments tend to remain, while social dysfunction in patients seems predictive of future psychopathology.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Social functioning in patients with depressive and anxiety disorders

Saris

Aghajani

Werff

et al. 2017

Acta Psychiatr Scand

150

View full text Add to dashboard Cite

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“…These data align with other studies that have shown that severe anxiety and depression are more predictive of social dysfunction than nonsevere anxiety and depression (24) and that panic patients with comorbid depression or personality disorder have worse treatment outcomes than patients with panic disorder alone (13,25,26). A lower education level was also found to be a risk factor for a worse quality of life in patients with panic disorder, but the reasons for this are not clear.…”

Section: Discussionsupporting

confidence: 90%

Panic disorder and quality of life: variables predictive of functional impairment

Hollifield

Katon²,

Skipper³

et al. 1997

AJP

111

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P anic attacks are highly prevalent in the United States (1), and 5%-8% of patients who present to primary care suffer from panic disorder; many more have infrequent panic attacks (2). People with panic attacks have a higher degree of functional disability than subjects without panic attacks (3). Panic disorder patients tend to be high users of health care services (3, 4), and they perceive their physical and emotional health to be much worse than comparison subjects (3, 5). They are also at higher risk for substance abuse, suicide attempts, marital problems, and financial dependency (6, 7).Leon and colleagues (8) analyzed the relationship between DSM-III-R symptoms in patients with panic disorder and functional impairment as measured by the Sheehan Disability Scales (9). The three clinical variables that were measured (frequency of attacks, percentage of time spent worrying about attacks, and degree of phobic anxiety) accounted for 37% of the variance in impairment, while the number of criterion symptoms during an attack and fear intensity did not add to impairment. Leon et al. concluded that DSM-III-R criteria account for less than half of the impairment experienced by patients with panic disorder and that other variables need to be studied (8).It is not known what other variables account for the impairment in patients with panic disorder. Other psychiatric disorders frequently coexist with panic. Between 44% and 91% of patients with panic disorder have major depression (10), and people with major de-

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“…This finding agrees with most clinical and epidemiological studies (Van Valkenburg et al 1984;Barlow et al 1986;Bullcr et al 1986;Charney et al 1986;Lesser et al 1988Lesser et al , 1989Reich 1988;Stein and Uhde 1988;Wittchen 1988;Cassano et al 1989;Hecht et al 1989;Maier et al 1989;Nagy et al 1989;Vollrath and Angst 1989;Noyes et al 1990;Vollrath et al 1990) and supports the hypothesis that patients with comorbid conditions are more severely ill. Additionally, the higher scores in the self-ratings (STAI-trait and SPRAS) indicate a more severe subjective suffering of these patients. One might assume that the longer duration of illness or the older age at index of the comorbid group have confounded the results.…”

Section: Discussionsupporting

confidence: 91%

“…Patients with comorbid conditions have been reported to lo have poorer psychosocial adjustment at outcome (Van Valkenburg et al 1984;Wittchen 1988;Hecht et al 1989), 5 more symptom-related disability at follow-up (Noyes et al 1990), lower recovery rates (Vollrath et al 1990) and 0 higher relapse rates (Reich 1988).…”

Section: Introductionmentioning

confidence: 97%

Prospective follow-up study lasting 2 years in patients with panic disorder with and without depressive disorders

Scheibe¹,

Albus²

1994

Eur Arch Psychiatry Clin Nuerosci

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A group of 52 patients presenting at an outpatient unit for anxiety disorders were included consecutively in a prospective 2-year follow-up study. Patients were administered to a structured interview for DSM-III-R diagnoses, a follow-up interview (LIFE), and various other ratings. Sociodemographic and illness-history characteristics, levels of anxiety and depressive symptoms, as well as psychosocial impairment, were evaluated at baseline and follow-up and compared between patients with panic disorder only and patients with panic disorder and concomitant depressive disorders at index assessment. Cross-sectional and longitudinal differences between patients with panic disorder only and patients with panic disorder and concomitant depression have been found, indicating that patients with comorbid conditions are more severely ill and have a less favorable outcome. For the total sample, however, the 2-year outcome was better than that reported in many other follow-up studies.

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Anxiety and depression: Comorbidity, psychopathology, and social functioning

Cited by 46 publications

References 27 publications

Social functioning in patients with depressive and anxiety disorders

Social functioning in patients with depressive and anxiety disorders

Panic disorder and quality of life: variables predictive of functional impairment

Prospective follow-up study lasting 2 years in patients with panic disorder with and without depressive disorders

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