Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder

Zhou, Yongjie; Cao, Zhongqiang; Yang, Mei; Xi, Xiaoyan; Guo, Yiyang; Fang, Maosheng; Cheng, Lijuan; Du, Yukai

doi:10.1038/srep40511

Cited by 152Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and AccessTreatment of Major Depression

Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder

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Zhou, Yongjie, Cao, Zhongqiang, Yang, Mei, Xi, Xiaoyan, Guo, Yiyang, Fang, Maosheng, Cheng, Lijuan, Du, Yukai·2017·Scientific Reports

DOI 10.1038/srep40511PMC PMC5241829

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Abstract

The comorbidity of major depressive disorder (MDD) and generalized anxiety disorder (GAD) is common and often predicts poorer outcomes than either disorder alone. This study aimed to examine the prevalence of comorbid GAD and its association with quality of life (QOL) among MDD patients. A total of 1225 psychiatric outpatients were screened using the Hospital Anxiety and Depression Scale (HADS). Those who scored ≥8 on the HADS were interviewed using DSM-IV criteria by two senior psychiatrists. Patients diagnosed with MDD were further assessed using the 9-item Patient Health Questionnaire, Social Support Rating Scale, Pittsburgh Sleep Quality Index, and World Health Organization QOL Scale, brief version (WHOQOL-BREF). Ultimately, 667 patients were diagnosed with MDD, of 71.7% of whom had GAD. Compared to those with MDD alone, comorbid patients had lower scores on the physical (38.64 ± 10.35 vs.36.54 ± 12.32, P = 0.026) and psychological (35.54 ± 12.98 vs. 30.61 ± 14.66, P < 0.001) domains of the WHOQOL-BREF. The association between comorbid GAD and poor QOL on the two domains remained statistically significant in the multiple linear regression (unstandardized coefficients: -1.97 and -4.65, P < 0.001). In conclusion, the prevalence of comorbid GAD in MDD patients is high, and co-occurring GAD may exacerbate impaired physical and psychological QOL in Chinese MDD patients.

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Of persons with lifetime MDD, 46% had at least one lifetime anxiety disorder.
“Of persons with lifetime MDD, 46% had at least one lifetime anxiety disorder, and of those with a 12-month MDD, 52% had lifetime anxiety disorders and 42% had 12-month anxiety disorders [30].”
From Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome (2018) · cites this paper as [30]
Of those with a 12-month MDD, 52% had lifetime anxiety disorders and 42% had 12-month anxiety disorders.
“Of persons with lifetime MDD, 46% had at least one lifetime anxiety disorder, and of those with a 12-month MDD, 52% had lifetime anxiety disorders and 42% had 12-month anxiety disorders [30].”
From Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome (2018) · cites this paper as [30]
Of those with lifetime comorbid anxiety disorder and MDD, 68% reported an earlier occurrence of their first anxiety disorder versus their MDD, 13.5% had anxiety follow after MDD onset, and 18.5% had parallel occurrence.
“In terms of temporal order, of those with lifetime comorbid anxiety disorder and MDD, 68% reported an earlier occurrence of their first anxiety disorder versus their MDD, whereas in 13.5% anxiety followed after MDD onset, and in 18.5% the occurrence of the anxiety disorder was parallel to that of depression [30].”
From Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome (2018) · cites this paper as [30]

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Furtado, M., Van Lieshout, R. J., Van Ameringen, M., Green, S. M., & Frey, B. N. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.02.064 · Cited by 50 · see citing works
Assessment of behavioral changes and antitumor effects of silver nanoparticles synthesized using diosgenin in mice model
Rajadurai, U. M., Hariharan, A., Siva, D., Ameén, F., Dawoud, T. M. S., Alwakeel, S., Palanivel, I., Prabha, A. L., & Jacob, J. A. (2021) · Journal of Drug Delivery Science and Technology · doi:10.1016/j.jddst.2021.102766 · Cited by 50 · see citing works
COVID-19 anxiety and quality of life among Iranian nurses
Tabrizi, Z. M., Mohammadzadeh, F., Quchan, A. D. M., & Bahri, N. (2022) · BMC Nursing · doi:10.1186/s12912-021-00800-2 · Cited by 49 · see citing works
“The results of other studies also showed a negative correlation between anxiety and quality of life [30, 31].”
Result
Economic and humanistic burden associated with noncommunicable diseases among adults with depression and anxiety in the United States
Armbrecht, E. S., Shah, A. M., Schepman, P. B., Shah, R., Pappadopulos, E. A., Chambers, R. B., Stephens, J., Haider, S., & McIntyre, R. S. (2020) · Journal of Medical Economics · doi:10.1080/13696998.2020.1776297 · Cited by 51 · see citing works
The impact of psychological treatment on intolerance of uncertainty in generalized anxiety disorder: A systematic review and meta-analysis
Wilson, E. J., Abbott, M. J., & Norton, A. R. (2023) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2023.102729 · Cited by 52 · see citing works
Associations between anxiety, depression, and personal mastery in community-dwelling older adults: a network-based analysis
Bian, Z., Xu, R., Shang, B., Lv, F., Sun, W., Li, Q., Gong, Y., & Luo, C. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05644-z · Cited by 42 · see citing works
“…anxiety and depression often leads to more severe consequences than anxiety or depression alone, not only leading to more severe psychological symptoms, higher risk of somatic chronic illness and more severe cognitive impairment in individuals, but also to a much higher risk of suicide [9–15].”
Background
The Anxiolytic and Antidepressant Effects of Transcranial Magnetic Stimulation in Patients With Anxious Depression
Hutton, T. M., Aaronson, S. T., Carpenter, L. L., Pages, K. P., West, W. S., Kraemer, C., & Sackeïm, H. A. (2023) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.22m14571 · Cited by 42 · see citing works
Well-being in major depression and social phobia with and without comorbidity
Wersebe, H., Lieb, R., Meyer, A. H., Miché, M., Mikoteit, T., Imboden, C., Hoyer, J., Bader, K., Hatzinger, M., & Gloster, A. T. (2018) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2018.06.004 · Cited by 41 · see citing works
“Our findings are consistent with those studies reporting lower quality of life (Cavicchioli et al., 2018; Norberg et al., 2008; Zhou et al., 2017) in individuals with comorbid disorders, perhaps due to the higher symptom burden, compared to individuals no comorbidity.”
MethodResult
Projecting the 10-year costs of care and mortality burden of depression until 2032: a Markov modelling study developed from real-world data
Chan, V. K. Y., Leung, M. Y. M., Chan, S. S. M., Yang, D., Knapp, M. R. J., Luo, H., Craig, D., Chen, Y., Bishai, D. M., Wong, G. H. Y., et al. (2024) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2024.101026 · Cited by 38 · see citing works
“39 All selected articles passed our quality assessment satisfactorily (Supplementary Tables S10A –”
Background
Untangling the tingle: Investigating the association between the Autonomous Sensory Meridian Response (ASMR), neuroticism, and trait & state anxiety
Eid, C. M., Hamilton, C., & Greer, J. M. H. (2022) · PLoS ONE · doi:10.1371/journal.pone.0262668 · Cited by 41 · see citing works
“Similar to individuals scoring higher in neuroticism, those with a diagnosis of MDD are more likely to have a clinical anxiety diagnosis [35].”
Background
Influence of comorbid anxiety symptoms on cognitive deficits in patients with major depressive disorder
Jin, L., Dong, Q., Lu, X., Sun, J., Zhang, L., Wang, M., Liu, B., Ju, Y., Wan, P., Guo, H., et al. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.08.091 · Cited by 36 · see citing works
Generalized anxiety disorder and associated factors in adults in the Amazon, Brazil: A population-based study
Silva, M. T., Caicedo‐Roa, M., Martins, S. S., da Silva, A. T. C., & Galvão, T. F. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.04.079 · Cited by 35 · see citing works
Factors Associated with the Development of Depression and the Influence of Obesity on Depressive Disorders: A Narrative Review
Alberti, A., Coelho, D. R. A., Vieira, W. F., Iser, B. P. M., Lampert, R., Traebert, E., da Silva, B. B., de Oliveira, B. H., Leão, G. M., de Souza, G., et al. (2024) · Biomedicines · doi:10.3390/biomedicines12091994 · Cited by 34 · see citing works
“Both disorders appear to have similar neurobiological underpinnings, inﬂuenced by neurochemical imbalances as well as genetic and environmental factors, making diagnosis and treatment particularly complex [95,96].”
Background
Comorbidity with more anxiety disorders associated with a poorer prognosis persisting at the 10-year follow-up among patients with major depressive disorder
Hung, C., Liu, C.-Y., Yang, C., & Gan, S. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.08.085 · Cited by 32 · see citing works
Minocycline as adjunctive treatment for major depressive disorder: Pooled data from two randomized controlled trials
Zazula, R., Husain, M. I., Mohebbi, M., Walker, A. J., Chaudhry, I. B., Khoso, A. B., Ashton, M. M., Agustini, B., Husain, N., Deakin, J., et al. (2021) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867420965697 · Cited by 31 · see citing works
“Possibly, improvements in depressive outcomes could occur through improvements in quality of life and anxiety symptoms rather than reduced severity of depression (Lewis et al., 2019; Zhou et al., 2017).”
Background
Effectiveness of vortioxetine in patients with major depressive disorder comorbid with generalized anxiety disorder: Results of the RECONNECT study
Christensen, M. C., Schmidt, S. N., & Grande, I. (2022) · Journal of Psychopharmacology · doi:10.1177/02698811221090627 · Cited by 31 · see citing works
“Major depressive disorder (MDD) and generalized anxiety disor der (GAD) are frequently comorbid, and individuals experien cing comorbid GAD represent one of the largest patient groups within the overall population with MDD (Dold et al., 2017; Hasin et al., 2018; Kessler et al., 2005; Lamers et al., 2011; Moffitt et…”
BackgroundInfluential
Evaluating Machine Learning Stability in Predicting Depression and Anxiety Amidst Subjective Response Errors
Ku, W. L., & Min, H. (2024) · Healthcare · doi:10.3390/healthcare12060625 · Cited by 30 · see citing works
“MDD and GAD are prevalent psychiatric conditions that significantly impact individuals’ mental health and overall well-being [1].”
Background
Vortioxetine in patients with major depressive disorder and high levels of anxiety symptoms: An updated analysis of efficacy and tolerability
Adair, M., Christensen, M. C., Florea, I., Loft, H., & Fagiolini, A. M. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.01.074 · Cited by 30 · see citing works
The influence of depression and anxiety on cognition in people with multiple sclerosis: a cross-sectional analysis
Freedman, D., Oh, J., Kiss, A., Puopolo, J., Wishart, M., Meza, C., & Feinstein, A. (2024) · Journal of Neurology · doi:10.1007/s00415-024-12409-x · Cited by 29 · see citing works
“The importance of comorbidity, which our findings high-light, fits with a broader psychiatric literature that links it with a poorer quality of life in people with major depressive disorder [39], heightened risk of memory decline in older adults [40], and increased mortality in heart failure [41].”
The genetic contribution to the comorbidity of depression and anxiety: a multi-site electronic health records study of almost 178 000 people
Coombes, B. J., Landi, I., Choi, K. W., Singh, K., Fennessy, B., Jenkins, G. D., Batzler, A. J., Pendegraft, R. S., Núñez, N. A., Gao, Y. N., et al. (2023) · Psychological Medicine · doi:10.1017/s0033291723000983 · Cited by 28 · see citing works
“…age of onset, more severe depression, increased suicidal ideation, poorer antidepressant response, psychosocial impairment, worse course of illness, and increased comorbidity with substance use disorders (Joffe, Bagby, & Levitt, 1993; Nam, Kim, & Roh, 2016; Pollack, 2005; Zhou et al., 2017).”
Background
Accelerated Transcutaneous Auricular Vagus Nerve Stimulation for Inpatient Depression and Anxiety: The iWAVE Open Label Pilot Trial
Austelle, C. W., Cox, S. S., Connolly, D. J., Vogel, B. B., Peng, X., Wills, K. E., Sutton, F., Tucker, K. B., Ashley, E., Manett, A. J., et al. (2025) · Neuromodulation Technology at the Neural Interface · doi:10.1016/j.neurom.2025.02.003 · Cited by 28 · see citing works
Prevalence of suicidality in clinically stable patients with major depressive disorder during the COVID-19 pandemic
Zhang, L., Cai, H. X., Bai, W., Zou, S., Feng, K.-X., Li, Y.-C., Liu, H., Du, X., Zeng, Z.-T., Lu, C.-M., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.03.042 · Cited by 27 · see citing works
“Therefore, it is reasonable to assume that patients with suicidality were more likely to have lower QOL in line with our results, which echo previous findings (Asrat et al., 2020; Li et al., 2017; Woo et al., 2014; Zhou et al., 2017).”
Economic and humanistic burden associated with depression and anxiety among adults with non‐communicable chronic diseases (NCCDs) in the United States
Armbrecht, E., Shah, R., Poorman, G. W., Luo, L., Stephens, J. M., Li, B., Pappadopulos, E., Haider, S., & McIntyre, R. S. (2021) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s280200 · Cited by 24 · see citing works
“Similarly, Zhou et al demonstrated that, among patients diagnosed with MDD, the presence of comorbid GAD decreased physical HRQOL.25 This effect was not seen in patients with no or few NCCDs in our analysis.”
Background
Symptoms of Depression and Anxiety and Subsequent Use of Nicotine and THC in Electronic Cigarettes
Clendennen, S. L., Smith, J., Sumbe, A., Chen, B., Wilkinson, A. V., & Harrell, M. B. (2023) · Substance Use & Misuse · doi:10.1080/10826084.2023.2177110 · Cited by 25 · see citing works
“Furthermore, comorbidity of clinically-diagnosed generalized anxiety disorder with major depressive disorder (hereafter referred to as comorbidity) is high, with estimates ranging from 48–71.7% (Cummings et al., 2014; Moffitt et al., 2007; Zhou et al., 2017).”
BackgroundInfluential
The Relationship between Achievement Motivation and Job Performance among Chinese Physicians: A Conditional Process Analysis
Guo, B., Qiang, B., Zhou, J., Yang, X., Qiu, X., Qiao, Z., Yang, Y., & Cao, D. (2021) · BioMed Research International · doi:10.1155/2021/6646980 · Cited by 22 · see citing works
“openness, extraversion, and neuroticism are crucial in personal performance and more prominent in the sales industry [54].”
Background
Validation of the intolerance of uncertainty scale as a screening tool for perinatal anxiety
Furtado, M., Frey, B. N., & Green, S. M. (2021) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-021-04296-1 · Cited by 22 · see citing works
The Dynamic Interplay of Anxious and Depressive Symptoms in a Sample of Undergraduate Students
Marian, Ș., Costantini, G., Macsinga, I., & Sava, F. A. (2022) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-022-10014-8 · Cited by 22 · see citing works
“, 1995), poorer quality of life (Zhou et al., 2017) and global functioning (FusarPoli et al.”
Background
Sex differences in amygdalohippocampal oscillations and neuronal activation in a rodent anxiety model and in response to infralimbic deep brain stimulation
Vila-Merkle, H., González-Martínez, A., Campos-Jiménez, R., Martínez‐Ricós, J., Teruel‐Martí, V., Lloret, A., Blasco‐Serra, A., & Cervera‐Ferri, A. (2023) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2023.1122163 · Cited by 22 · see citing works
“, 2023), and a greater deterioration of the quality of life of individuals (Zhou et al., 2017; Saha et al., 2021).”
Background
New Path to Recovery and Well-Being: Cross-Sectional Study on WeChat Use and Endorsement of WeChat-Based mHealth Among People Living With Schizophrenia in China
Yu, Y., Li, Y., Li, T., Xi, S., Xiao, X., Xiao, S., & Tebes, J. K. (2020) · Journal of Medical Internet Research · doi:10.2196/18663 · Cited by 21 · see citing works
“The Chinese version of GAD-7 has also been widely shown to be both culturally acceptable and psychometrically valid [43,44].”
Background
Functional near-infrared spectroscopy (fNIRS) in patients with major depressive disorder, generalized anxiety disorder and their comorbidity: Comparison with healthy controls
Shen, Y., Wu, B., Yu, J., Mou, L., Wang, Z., & Shen, X. (2025) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2025.104382 · Cited by 20 · see citing works
Attentional networks in co-occurring generalized anxiety disorder and major depression disorder: Towards a staging approach to the executive control deficits
Coussement, C., Longueville, X. D., & Heeren, A. (2021) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2021.152294 · Cited by 19 · see citing works
Revisiting Treatment Options for Depressed Patients with Generalised Anxiety Disorder
Goodwin, G. M. (2021) · Advances in Therapy · doi:10.1007/s12325-021-01861-0 · Cited by 19 · see citing works
Mental disorders, comorbidities, and suicidality at 30 years of age in a Brazilian birth cohort
Quevedo, L. D. Á., de Mola, C. L., Pearson, R. M., Murray, J., Hartwig, F. P., Gonçalves, H., Pinheiro, R. T., Gigante, D. P., Motta, J. V. D. S., de Quadros, L. D. C. M., et al. (2020) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2020.152194 · Cited by 19 · see citing works
Review of the Assessment and Management of Perinatal Mood and Anxiety Disorders
Weingarten, S. J., & Osborne, L. M. (2024) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20230023 · Cited by 17 · see citing works
Relationship between self-management of patients with anxiety disorders and their anxiety level and quality of life: A cross-sectional study
Cao, X., Feng, M., Ge, R., Wen, Y., Yang, J., & Li, X. (2023) · PLoS ONE · doi:10.1371/journal.pone.0284121 · Cited by 17 · see citing works
Which client with generalized anxiety disorder benefits from a mindfulness ecological momentary intervention versus a self-monitoring app? Developing a multivariable machine learning predictive model
Zainal, N. H., & Newman, M. G. (2024) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2024.102825 · Cited by 17 · see citing works
Association between physical activity and comorbid anxiety/depression in 46 low- and middle-income countries
Ma, R., Romano, E., Vancampfort, D., Firth, J., Stubbs, B., & Koyanagi, A. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.10.002 · Cited by 16 · see citing works
Do exercise trials for adults with depression account for comorbid anxiety? A systematic review
Bond, G., Stanton, R., Wintour, S.-A., Rosenbaum, S., & Rebar, A. L. (2020) · Mental health and physical activity · doi:10.1016/j.mhpa.2020.100320 · Cited by 16 · see citing works
The Oscillatory Profile Induced by the Anxiogenic Drug FG-7142 in the Amygdala–Hippocampal Network Is Reversed by Infralimbic Deep Brain Stimulation: Relevance for Mood Disorders
Vila-Merkle, H., González-Martínez, A., Campos-Jiménez, R., Martínez‐Ricós, J., Teruel‐Martí, V., Blasco‐Serra, A., Lloret, A., Celada, P., & Cervera‐Ferri, A. (2021) · Biomedicines · doi:10.3390/biomedicines9070783 · Cited by 16 · see citing works
“Anxiety and depression are often comorbid and, when they occur together, the pathology presents a diminished clinical outcome and quality of life [6].”
Background
Preliminary evidence of acylated ghrelin association with depression severity in postmenopausal women
Naufel, M. F., Pedroso, A. P., Oyama, L. M., Telles, M. M., Hachul, H., & Ribeiro, E. B. (2021) · Scientific Reports · doi:10.1038/s41598-021-84431-2 · Cited by 18 · see citing works
Characterising anxiety in major depressive disorder and its use in predicting antidepressant treatment outcome: An iSPOT-D report
Braund, T. A., Palmer, D. M., Williams, L. M., & Harris, A. W. (2019) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867419835933 · Cited by 15 · see citing works
Gender differences in prevalence and clinical correlates of anxiety symptoms in first-episode and drug-naïve patients with major depressive disorder
Yang, W., Qu, M., Fang, H.-L., Phan, A. T., Wu, H. E., Lang, X., & Zhang, X. (2021) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2021.152275 · Cited by 15 · see citing works
Differential co-expression networks of the gut microbiota are associated with depression and anxiety treatment resistance among psychiatric inpatients
Thompson, D. S., Fu, C., Gandhi, T., Fowler, J. C., Frueh, B. C., Weinstein, B. L., Petrosino, J. F., Hadden, J. K., Carlson, M. M., Coarfa, C., et al. (2022) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2022.110638 · Cited by 16 · see citing works
Comorbid anxiety in depression and rTMS treatment response: A retrospective study
Kazemi, R., Rostami, R., Rezaei, M., Hedayati, S., Khomami, S., & Hadipour, A. L. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.01.148 · Cited by 14 · see citing works
Uptake and impact of journaling program on wellbeing of NICU parents
Russell, L. N., Gregory, M. L., Warren, Z. E., & Weitlauf, A. S. (2021) · Journal of Perinatology · doi:10.1038/s41372-021-00983-1 · Cited by 14 · see citing works
Anxiolytic and Antidepressant-like Effects of Monoterpene Tetrahydrolinalool andIn silicoApproach of new Potential Targets
da Silva, P. R., Pazos, N. D. N., Gonzaga, T. K. S. D. N., Andrade, J., Monteiro, Á. B., Portela, A. C. R., Pires, H. F. O., Maia, M. D. S., da Fonsêca, D. V., Scotti, L., et al. (2022) · Current Topics in Medicinal Chemistry · doi:10.2174/1568026622666220505104726 · Cited by 14 · see citing works
Resting-State EEG Alterations of Practice-Related Spectral Activity and Connectivity Patterns in Depression
Tatti, E., Cinti, A., Serbina, A., Luciani, A., D’Urso, G., Cacciola, A., Quartarone, A., & Ghilardi, M. F. (2024) · Biomedicines · doi:10.3390/biomedicines12092054 · Cited by 14 · see citing works
Academic self-efficacy and cognitive strategy use in college students with and without depression or anxiety
Karr, J. E., & White, A. E. (2022) · Journal of American College Health · doi:10.1080/07448481.2022.2076561 · Cited by 17 · see citing works
“33 The observed rates of depression and anxiety were fairly high, but comparable to other estimates among college students taken during the COVID-19 pandemic.”
Result
Prevalence and risk factors of depression and anxiety in primary care
Chua, Y. C. E., Lin, Y. C., Lew, J. K., Won, S. K. W., Soon, W. S. W., Wan, J., Abdin, E., Subramaniam, M., Tang, W. E., & Lee, E. S. (2024) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.2023195 · Cited by 12 · see citing works
Cognitive function associated with different diagnoses of anxiety disorders over the lifespan: Results from a Spanish representative sample
Gayete, S., Rabadan, A. G., Miret, M., Ayuso‐Mateos, J. L., Haro, J. M., & Olaya, B. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102296 · Cited by 12 · see citing works
Validation of an 8-item Recovery Assessment Scale (RAS-8) for people with schizophrenia in China
He, S., Fang, Y., Huang, Z.-X., & Yu, Y. (2021) · Health and Quality of Life Outcomes · doi:10.1186/s12955-021-01763-3 · Cited by 13 · see citing works
Impacts of Digital Care Programs for Musculoskeletal Conditions on Depression and Work Productivity: Longitudinal Cohort Study
Costa, F. M. T. A., Janela, D., Molinos, M., Moulder, R. G., Jr., Bento, V., Laíns, J., Scheer, J. K., Yanamadala, V., Cohen, S. P., & Correia, F. D. (2022) · Journal of Medical Internet Research · doi:10.2196/38942 · Cited by 12 · see citing works
Practical pathway for the management of depression in the workplace: a Canadian perspective
Chokka, P. R., Bender, A., Brennan, S., Ahmed, G., Corbière, M., Dozois, D. J. A., Habert, J., Harrison, J., Katzman, M. A., McIntyre, R. S., et al. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1207653 · Cited by 12 · see citing works
“Depression and anxiety are frequently comorbid, with around 50% of patients with MDD also suffering an anxiety disorder in their lifetime (97, 98).”
Background
Association between anxiety, depression and quality of life in male and female German students during the COVID-19 pandemic
Wilzer, E., Zeisel, A., Roessner, V., & Ring, M. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05611-8 · Cited by 11 · see citing works
“Overall, especially symptoms of anxiety and depressive disorders seem to be related to poorer QoL [9, 12–14 , 17].”
BackgroundMethod
Comorbid Anxiety and Suicidal Behaviors in American Adolescents With Major Depression
Mathialagan, K., Amuk, Ö. C., Eskander, N., & Patel, R. S. (2020) · Cureus · doi:10.7759/cureus.8598 · Cited by 11 · see citing works
“Although there was a female preponderance in regard to comorbid disorder, there were no significant differences related to family income and education anxiety [19].”
Background
Positive emotion regulation strategies as mediators in depression and generalized anxiety disorder symptoms: A Transdiagnostic framework investigation
Abasi, I., Shams, G., Vera, B. P., Milosevic, I., Bitarafan, M., Ghanadanzadeh, S., & Moghaddam, M. T. (2021) · Current Psychology · doi:10.1007/s12144-021-01392-5 · Cited by 13 · see citing works
Additive, Curvilinear, and Interactive Relations of Anxiety and Depression With Indicators of Psychosocial Functioning
Cowden, R. G., Chapman, I., & Houghtaling, A. (2020) · Psychological Reports · doi:10.1177/0033294120918809 · Cited by 10 · see citing works
“628 Psychological Reports 124(2) Evidence from a range of studies (e.g., Fusar-Poli et al., 2014; Saris et al., 2017; Zhou et al., 2017) suggests that relations of comorbid anxiety and depression with diminished psychological and interpersonal functioning are amplified when compared to the effects…”
Background
Treatment of anxiety symptoms in patients receiving rTMS for treatment resistant depression
Tuinstra, D., Percifield, C., Stilwell, K., Plattner, A., Edwards, E., Sanders, W., & Koval, M. (2021) · Psychiatry Research Communications · doi:10.1016/j.psycom.2021.100014 · Cited by 10 · see citing works
Interpersonal Counseling for College Students: Pilot Feasibility and Acceptability Study.
Rafaeli, A. K., Bar-Kalifa, E., Verdeli, H., & Miller, L. (2021) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.20200038 · Cited by 4 · see citing works
“Third, depression, both in general (39, 40) and in this target age group (41–43), is often comorbid with anxiety disorders; in particular, the social challenges of adolescence and emerging adulthood and the transition from home life to college life often have the most severe impact on socially anxious individuals (44).”
Background
Comorbidity of depression and anxiety in clinical practice
Петрова, Н. Н., Palkin, Y. R., Валерьевич, Ф. Д., & Zinovieva, A. G. (2021) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202112104131 · Cited by 10 · see citing works
GWAS SNPs Impact Shared Regulatory Pathways Amongst Multimorbid Psychiatric Disorders and Cognitive Functioning
Golovina, E., Vickers, M. H., Erb, C. D., & O'Sullivan, J. M. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.560751 · Cited by 8 · see citing works
Distinct Effects of Anxiety and Depression on Updating Emotional Information in Working Memory
Zhang, Y., Boemo, T., Qiao, Z., Tan, Y., & Li, X. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010544 · Cited by 10 · see citing works
“Studies in clinical populations have shown that the comorbidity of anxiety and depression predicts poorer outcomes than either disorder considered individually [30,31].”
Background
Predictors and moderators of quality of life in patients with major depressive disorder: An AGTs-MDD study report
Yang, L., Wu, Z., Cao, L., Wang, Y., Su, Y., Huang, J., Fang, M., Yao, Z., Wang, Z., Wang, F., et al. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.03.063 · Cited by 8 · see citing works
The diagnosis and therapy of comorbid anxiety and depression disorders in clinical practice
Петрова, Н. Н., & Савицкая, К. С. (2021) · V M BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY · doi:10.31363/2313-7053-2021-1-102-112 · Cited by 8 · see citing works
“Котимия сопряжена с худшим исходом в плане социального функционирования пациентов и прогнозом в целом, чем у пациентов с изолированными расстройствами [22], а уровень депрессии выше, качество жизни ниже, расстройства сна выражены больше по сравнению с изолированной депрессией [39].”
Prevalence and correlates of common mental disorders among participants of the Uganda Genome Resource: Opportunities for psychiatric genetics research
Kalungi, A., Kinyanda, E., Akena, D. H., Gelaye, B., Ssembajjwe, W. J., Mpango, R. S., Ongaria, T. A., Mugisha, J. O., Makanga, R., Kakande, A., et al. (2024) · Molecular Psychiatry · doi:10.1038/s41380-024-02665-8 · Cited by 8 · see citing works
“Collectively, this effort will encompass 10,000 participants; all of these will have their DNA sequenced using the blended genome-exome technology at the Broad Institute in the United States.”
Gastrointestinal health: An investigation of mediating effects on mood and quality of life
Ross, E. J., Vivier, H., Cassisi, J. E., & Dvorak, R. D. (2020) · Health Psychology Open · doi:10.1177/2055102920974524 · Cited by 8 · see citing works
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Authors: Zhou, Y., Cao, Z., Yang, M., Xi, X., Guo, Y., Fang, M., Cheng, L., & Du, Y.
Affiliations: Huazhong University of Science and Technology (CN)
Corresponding author: Du, Yukai
ORCID: Zhou, Yongjie
Cao, Zhongqiang
Yang, Mei
Guo, Yiyang
Cheng, Lijuan
Du, Yukai
Venue: Scientific Reports
Publisher: Springer Science and Business Media LLC
Published: 2017-01-18
Volume: 7
Issue: 1
Pages: 40511-40511
ISSN: 2045-2322 (ISSN-L)
DOI: 10.1038/srep40511
PMC: PMC5241829
OpenAlex: W2574192814
Cited by: 152
References: 49
Citations by year: 2026: 11 · 2025: 21 · 2024: 29 · 2023: 21 · 2022: 19 · 2021: 22 · 2020: 13 · 2019: 9 · 2018: 6 · 2017: 1
FWCI: 10.25
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: Scientific Reports (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords: generalized anxiety disorder, major depressive disorder, comorbidities, quality of life, WHOQOL-BREF, physical health, psychological well-being, psychiatric outpatients, Chinese patients
MeSH terms: Adolescent, Adult, Aged, Anxiety Disorders, Demography, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Quality of Life, Sleep, Social Support, Comorbidity, Prevalence, Multivariate Analysis, Linear Models, Young Adult

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Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder

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