The effects of anxiety, substance use and conduct disorders on risk of major depressive disorder
Abstract
BACKGROUND: Major depressive disorder (MDD) is highly co-morbid with other Axis I disorders, which commonly precede its onset. We sought to determine the level and periods of risk for MDD posed by prior or co-occurring psychiatric disorders. METHOD: Using retrospective data from a longitudinal, population-based sample of 2926 male and 1929 female adult twin subjects, we predicted the hazard rates for MDD from a Cox proportional hazards model with same-year or prior onsets of co-morbid Axis I disorders as time-dependent covariates. RESULTS: All axis I disorders studied (generalized anxiety disorder, panic disorder, phobia, alcohol dependence, psychoactive substance use disorders and conduct disorder) significantly predicted increased risk for developing MDD. The highest hazard rates occurred for MDD onsets that co-occurred with those of the co-morbid disorder. However, the risk for onset of MDD subsequent to that of prior disorders is also significantly increased and remains relatively unchanged over time. Although the risk for onset of MDD is significantly higher in women than men, this was not explained by gender differences in prior disorder prevalence or increased sensitivity in women to the effects of prior disorders on risk for depression. CONCLUSIONS: Prior psychiatric disorders are significant risk factors for the development of MDD, independent of the length of the intervening period between the onset of the first disorder and that of MDD.
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Depressive symptoms are usually secondary to GAD.
“These results may be partially explained by the findings that depressive symptoms are usually secondary to GAD (Hettema, Prescott, & Kendler, 2003).”
From Efficacy of an acceptance-based group behavioral therapy for generalized anxiety disorder. (2020) · cites this paper as Hettema, Prescott, & Kendler, 2003
Clinical trials have produced evidence favorable to the improvement of both worry and depressive symptoms in individuals with GAD.
“Clinical trials have produced evidence favorable to the improvement of both these sets of symptoms in individuals with GAD 9 .”
From Relationships between worry and depressive symptoms during two group therapies for generalized anxiety disorder (2022) · cites this paper as [9]
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- Authors
- HETTEMA, J. M., PRESCOTT, C. A., & KENDLER, K. S.
- Affiliations
- Virginia Commonwealth University (US)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2003-10-30
- Volume
- 33
- Issue
- 8
- Pages
- 1423-1432
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2077221760
- Cited by
- 77
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2022: 1 · 2021: 1 · 2020: 5 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 2 · 2014: 3 · 2013: 3 · 2012: 3
- FWCI
- 8.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA009095, AA-09095)
- National Institute of Mental Health (R01MH040828, MH 40828, MH/AA/DA-49492)
- National Institute on Drug Abuse (DA11287, R01DA011287)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- major depressive disorder, comorbidities, anxiety disorders, generalized anxiety disorder, panic disorder, phobia, substance use disorders, alcoholism, conduct disorder, psychiatric risk factors, onset time, gender differences, twin cohort
- MeSH terms
- Adult, Alcoholism, Anxiety Disorders, Depressive Disorder, Major, Major Depressive Disorder, Diseases in Twins, Female, Humans, Longitudinal Studies, Male, Middle Aged, Phobic Disorders, Registries, Retrospective Studies, Risk, Sex Factors, Virginia, Comorbidity, Causality, Proportional Hazards Models, Panic Disorder, Conduct Disorder, Substance-Related Disorders
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