DIAGNOSTIC OVERLAP OF GENERALIZED ANXIETY DISORDER AND MAJOR DEPRESSIVE DISORDER IN A PRIMARY CARE SAMPLE
Corresponding Author
Tomislav D. Zbozinek B.A.
Department of Psychology, University of California, Los Angeles, California
Correspondence to: Tomislav D. Zbozinek, Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA 90095. E-mail: [email protected]Search for more papers by this authorRaphael D. Rose Ph.D.
Department of Psychology, University of California, Los Angeles, California
Search for more papers by this authorKate B. Wolitzky-Taylor Ph.D.
Department of Psychology, University of California, Los Angeles, California
Search for more papers by this authorCathy Sherbourne Ph.D.
The RAND Corporation, Santa Monica, California
Search for more papers by this authorGreer Sullivan M.D., M.S.P.H.
University of Arkansas for Medical Sciences, Little Rock, Arkansas
Search for more papers by this authorMurray B. Stein M.D., M.P.H.
Department of Psychiatry and Department of Family & Preventive Medicine, University of California, San Diego, California
Search for more papers by this authorPeter P. Roy-Byrne M.D.
University of Washington at Harborview Medical Center and CHAMMP, Seattle, Washington
Search for more papers by this authorMichelle G. Craske Ph.D.
Department of Psychology, University of California, Los Angeles, California
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
Search for more papers by this authorCorresponding Author
Tomislav D. Zbozinek B.A.
Department of Psychology, University of California, Los Angeles, California
Correspondence to: Tomislav D. Zbozinek, Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA 90095. E-mail: [email protected]Search for more papers by this authorRaphael D. Rose Ph.D.
Department of Psychology, University of California, Los Angeles, California
Search for more papers by this authorKate B. Wolitzky-Taylor Ph.D.
Department of Psychology, University of California, Los Angeles, California
Search for more papers by this authorCathy Sherbourne Ph.D.
The RAND Corporation, Santa Monica, California
Search for more papers by this authorGreer Sullivan M.D., M.S.P.H.
University of Arkansas for Medical Sciences, Little Rock, Arkansas
Search for more papers by this authorMurray B. Stein M.D., M.P.H.
Department of Psychiatry and Department of Family & Preventive Medicine, University of California, San Diego, California
Search for more papers by this authorPeter P. Roy-Byrne M.D.
University of Washington at Harborview Medical Center and CHAMMP, Seattle, Washington
Search for more papers by this authorMichelle G. Craske Ph.D.
Department of Psychology, University of California, Los Angeles, California
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
Search for more papers by this authorAbstract
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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