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Current Comorbidity of Psychiatric Disorders Among DSM-IV Major Depressive Disorder Patients in Psychiatric Care in the Vantaa Depression Study
Abstract
BACKGROUND: While numerous studies have documented the high comorbidity of major depressive disorder (MDD) with individual mental disorders, no published study has reported overall current comorbidity with all Axis I and II disorders among psychiatric patients with MDD, nor systematically investigated variations in current comorbidity by sociodemographic factors, inpatient versus outpatient status, and number of lifetime depressive episodes. METHOD: Psychiatric outpatients and inpatients in Vantaa, Finland, were prospectively screened for an episode of DSM-IV MDD, and 269 patients with a new episode of MDD were enrolled in the Vantaa Depression MDD Cohort Study. Axis I and II comorbidity was assessed via semistructured Schedules for Clinical Assessment in Neuropsychiatry, version 2.0, and Structured Clinical Interview for DSM-II-R personality disorders interviews. RESULTS: The great majority (79%) of patients with MDD suffered from 1 or more current comorbid mental disorders, including anxiety disorder (57%), alcohol use disorder (25%), and personality disorder (44%). Several anxiety disorders were associated with specific Axis II clusters, and panic disorder with agoraphobia was associated with inpatient status. The prevalence of personality disorders varied with inpatient versus outpatient status, number of lifetime depressive episodes, and type of residential area, and the prevalence of substance use disorders varied with gender and inpatient versus outpatient status. CONCLUSION: Most psychiatric patients with MDD have at least 1 current comorbid disorder. Comorbid disorders are associated not only with other comorbid disorders, but also with sociodemographic factors, inpatient versus outpatient status, and lifetime number of depressive episodes. The influence of these variations on current comorbidity patterns among MDD patients needs to be taken account of in treatment facilities.
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“Large-scale cohort studies have documented that clinical populations have interindividual variability with substantial heterogeneity in types of comorbidity and aetiological risk (Lamers et al., 2010;Melartin et al., 2002;Sterling et al., 2008;Wessman et al., 2009).”
From Meta-analysis of the effects of intranasal oxytocin on interpretation and expression of emotions (2017) · cites this paper as Melartin et al., 2002
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“Another possible interpretation of the present findings is that there is substantial heterogeneity within and between clinical groups that could dilute the true effects of intranasal oxytocin on social threat processing among clinical populations (Lamers et al., 2010;Melartin et al., 2002;Wessman et al., 2009).”
From Meta-analytic review of the effects of a single dose of intranasal oxytocin on threat processing in humans (2018) · cites this paper as Melartin et al., 2002
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Hasin, D. S., Stinson, F. S., Ogburn, E., & Grant, B. F. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.7.830 · Cited by 2,908
Compton, W. M., Thomas, Y. F., Stinson, F. S., & Grant, B. F. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.5.566 · Cited by 1,152
The prevalence of DSM-IV personality disorders in psychiatric outpatients
Zimmerman, M., Rothschild, L., & Chelminski, I. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.10.1911 · Cited by 825
Major depression and comorbid substance use disorders
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The prevalence and impact of alcohol problems in major depression: A systematic review
Sullivan, L. E., Fiellin, D. A., & O’Connor, P. G. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.01.007 · Cited by 489
Metadata
- Authors
- Melartin, T. K., Rytsala, H. J., Leskela, U. S., Lestela-Mielonen, P. S., Sokero, T. P., & Isometsa, E. T.
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2002-02-15
- Volume
- 63
- Issue
- 2
- Pages
- 126-134
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W1967325475
- Cited by
- 260
- References
- 0
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 2 · 2021: 7 · 2020: 9 · 2019: 10 · 2018: 17 · 2017: 18 · 2016: 13 · 2015: 6 · 2014: 9 · 2013: 17 · 2012: 12
- FWCI
- 13.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- major depressive disorder, psychiatric comorbidity, anxiety disorders, personality disorders, substance use disorders, alcoholism, panic disorder, agoraphobia, sociodemographic factors
- MeSH terms
- Adult, Age Factors, Ambulatory Care, Anxiety Disorders, Mental Disorders, Depressive Disorder, Female, Finland, Health Services Research, Hospitalization, Humans, Male, Personality Disorders, Psychiatric Status Rating Scales, Sex Factors, Comorbidity, Prevalence, Marital Status, Substance-Related Disorders
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