Depression Comorbid with Anxiety: Results from the WHO Study on Psychological Disorders in Primary Health Care
Abstract
The World Health Organization collaborative study on “Psychological Problems in General Health Care” investigated the form, frequency, course and outcome of common psychological problems in primary care settings at 15 international sites. The research employed a two-stage case-finding procedure. GHQ–12 was administered to 25 916 adults who consulted health-care services. The second-stage assessment (n=5438) consisted of the Composite International Diagnostic Interview (GDI), the Social Disability Schedule, and questionnaires. Possible cases or borderline cases of mental disorder, and a sample of known cases, were followed up at three months and one year. Using standard diagnostic algorithms (ICD–10), prevalence rates were calculated for current disorder (one-month) and lifetime experience disorder. Well-defined psychological problems are frequent in all the general health-care settings examined (median 24.0%). Among the most common were depression, anxiety, alcohol misuse, somatoform disorders, and neurasthenia. Nine per cent of patients suffered from a “subthreshold condition” that did not meet diagnostic criteria but had clinically significant symptoms and functional impairment. The most common co-occurrence was depression and anxiety. Comorbidity increases the likelihood of recognition of mental disorders in general health care, and the likelihood of receiving treatment.
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Nearly half of all cases of depression and anxiety occur in the same patients at the same time.
“Research has shown that nearly half of all cases of depression and anxiety occur in the same patients at the same time [74].”
From Correlations between social media addiction and anxiety, depression, FoMO, loneliness and self-esteem among students: A systematic review and meta-analysis (2025) · cites this paper as [74]
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“This may explain why so few of our QTL overlap with this previous study.”
BackgroundResultGaynes, B. N., Magruder, K. M., Burns, B. J., Wagner, H. R., Yarnall, K. S. H., & Broadhead, W. E. (1999) · General Hospital Psychiatry · doi:10.1016/s0163-8343(99)00005-5 · Cited by 116 · see citing works
“Second, anxiety disorders commonly coexist with major depression in primary care settings, with reports of comorbidity ranging from 28% to 66% [15,27–31].”
BackgroundClarke, K., King, M., & Prost, A. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001541 · Cited by 122 · see citing works
“We include interventions for all PCMDs since depression and anxiety often coexist, and subcategories of common mental disorder may lack conceptual validity in some cultures [16–18].”
MethodSilexan in anxiety disorders: Clinical data and pharmacological background
Kasper, S. F., Müller, W. E., Volz, H., Möller, H., Koch, E., & Dienel, A. (2017) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2017.1331046 · Cited by 136 · see citing works
“Due to the high prevalence of concomitant occurrence of symptoms of depression in anxiety disorders (Sartorius et al. 1996), all aforementioned efficacy trials assessed the effect of Silexan on co-morbid depression as a secondary efficacy outcome measure.”
BackgroundHegerl, U., Hautzinger, M., Mergl, R., Kohnen, R., Schütze, M., Scheunemann, W., Allgaier, A., Coyne, J., & Henkel, V. (2010) · International Journal of Neuropsychopharmacology · doi:10.1017/s1461145709000224 · Cited by 120 · see citing works
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Confirmatory Factor Analysis of the GHQ-12: Can I See that Again?
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Validation of the hospital anxiety and depression scale in patients with acute low back pain
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Deep neural networks detect suicide risk from textual facebook posts
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“92 [2 5 7 ] 0.”
Ansseau, M., Fischler, B., Dierick, M., Albert, A., Leyman, S., & Mignon, A. (2008) · Depression and Anxiety · doi:10.1002/da.20306 · Cited by 114 · see citing works
“9% but approximated 8% in several studies [Maier et al., 2000; Sartorius et al., 1996; Ustun and Sartorius, 1995; Wittchen, 2001].”
BackgroundResultInfluentialThe Turker Blues: Hidden Factors Behind Increased Depression Rates Among Amazon’s Mechanical Turkers
Ophir, Y., Sisso, I., Asterhan, C. S. C., Tikochinski, R., & Reichart, R. (2019) · Clinical Psychological Science · doi:10.1177/2167702619865973 · Cited by 124 · see citing works
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“The two sub-scales were significantly correlated, this correlation could be explained by the known comorbidity between depression and anxiety [55,79,80].”
BackgroundDepressive disorders in primary care: recurrent, chronic, and co-morbid
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“Prevalence rates of 23–50% have been reported for co-morbid anxiety disorders (Sherbourne et al. 1996; Gaynes et al. 1999; Lenze et al. 2000), and 6–27% for co-morbid substance use disorders (Coyne et al. 1994; Sartorius et al. 1996; Roeloffs et al. 2001).”
BackgroundSchwarzbold, M., Rial, D., Bem, T. D., Machado, D. G., Cunha, M., dos Santos, A. A., dos Santos, D. D., Figueiredo, C. P., Farina, M., Goldfeder, E., et al. (2010) · Journal of Neurotrauma · doi:10.1089/neu.2010.1318 · Cited by 111 · see citing works
“Depression is one of the most common sequelae of TBI, and comorbidity with anxiety is common in the general population and in TBI patients (Jorge et al., 1993; Sartorius et al., 1996).”
Becker, S. P., Holdaway, A. S., & Luebbe, A. M. (2018) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2018.02.013 · Cited by 110 · see citing works
“Depression, anxiety, and attention-deficit/ hyperactivity disorder (ADHD) are the most common mental health problems experienced by college students [18, 19], and these mental health problems are themselves strongly intercorrelated [20, 21].”
BackgroundCognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.
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Epidemiology of depression in diabetes: International and cross-cultural issues
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“The World Health Organization multicountry study demonstrated that primary care physicians in their study centres detected only half of all cases of depression (Sartorius et al., 1996).”
BackgroundScreening for anxiety disorders
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Self-citationDoi, S., Ito, M., Takebayashi, Y., Muramatsu, K., & Horikoshi, M. (2018) · PLoS ONE · doi:10.1371/journal.pone.0199235 · Cited by 95 · see citing works
- Authors
- Sartorius, N., Üstün, T. B., Lecrubier, Y., & Wittchen, H.-U.
- Affiliations
- University of Geneva (CH)
- World Health Organization (CH)
- Inserm (FR)
- Corresponding author
- Üstün, T. Bedirhan
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 1996-06
- Volume
- 168
- Issue
- S30
- Pages
- 38-43
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2765030473
- Cited by
- 541
- References
- 0
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 6 · 2023: 23 · 2022: 13 · 2021: 19 · 2020: 28 · 2019: 26 · 2018: 21 · 2017: 17 · 2016: 17 · 2015: 21 · 2014: 18 · 2013: 17 · 2012: 24
- FWCI
- 18.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Max Planck Institute for Plasma Physics (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- depression, anxiety, comorbidities, primary care, mental illness, prevalence, mental disorder recognition, treatment seeking, alcohol abuse, somatoform disorders, neurasthenia
- MeSH terms
- Adolescent, Adult, Aged, Antidepressive Agents, Anxiety Disorders, Chronic Disease, Depressive Disorder, Female, Humans, Male, Middle Aged, Primary Health Care, Professional Impairment, Psychotropic Drugs, Sampling Studies, World Health Organization, Comorbidity, Prevalence, Odds Ratio
About these checks
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