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Cited by 272Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and Access

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What Characteristics of Primary Anxiety Disorders Predict Subsequent Major Depressive Disorder?

Bittner, Antje, Goodwin, Renee D., Wittchen, Hans-Ulrich, Beesdo, Katja, Höfler, Michael, Lieb, Roselind·2004·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.v65n0505
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Abstract

OBJECTIVE: The goal of this study was to examine the associations between specific anxiety disorders and the risk of major depressive disorder and to explore the role of various clinical characteristics of anxiety disorders in these relationships using a prospective, longitudinal design. METHOD: The data are from a 4-year prospective, longitudinal community study, which included both baseline and follow-up survey data on 2548 adolescents and young adults aged 14 to 24 years at baseline. DSM-IV diagnoses were made using the Munich-Composite International Diagnostic Interview. RESULTS: The presence at baseline of any anxiety disorder (odds ratio [OR] = 2.2 [95% CI = 1.6 to 3.2]) and each of the anxiety disorders (specific phobia, OR = 1.9 [95% CI = 1.3 to 2.8]; social phobia, OR = 2.9 [95% CI = 1.7 to 4.8]; agoraphobia, OR = 3.1 [95% CI = 1.4 to 6.7]; panic disorder, OR = 3.4 [95% CI = 1.2 to 9.0]; generalized anxiety disorder, OR = 4.5 [95% CI = 1.9 to 10.3]) was associated with a significantly (p <.05) increased risk of first onset of major depressive disorder. These associations remained significant after we adjusted for mental disorders occurring prior to the onset of the anxiety disorder, with the exception of the panic disorder association. The following clinical characteristics of anxiety disorders were associated with a significantly (p <.05) increased risk of developing major depressive disorder: more than 1 anxiety disorder, severe impairment due to the anxiety disorder, and comorbid panic attacks. In the final model, which included all clinical characteristics, severe impairment remained the only clinical characteristic that was an independent predictor of the development of major depressive disorder (OR = 2.2 [95% CI = 1.0 to 4.4]). CONCLUSION: Our findings suggest that anxiety disorders are risk factors for the first onset of major depressive disorder. Although a number of clinical characteristics of anxiety disorders appear to play a role in the association between anxiety disorders and depression, severe impairment is the strongest predictor of major depressive disorder.

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Metadata

Authors
Bittner, A., Goodwin, R. D., Wittchen, H.-U., Beesdo, K., Höfler, M., & Lieb, R.
Affiliations
  • Technische Universität Dresden (DE)
  • Max Planck Society (DE)
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2004-05-15
Volume
65
Issue
5
Pages
618-626
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.v65n0505
OpenAlex
W2045928247
Cited by
272
References
0
Citations by year
2026: 5 · 2025: 5 · 2024: 7 · 2023: 10 · 2022: 11 · 2021: 20 · 2020: 14 · 2019: 10 · 2018: 7 · 2017: 17 · 2016: 15 · 2015: 19 · 2014: 17 · 2013: 15 · 2012: 15
FWCI
15.17
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Max Planck Institute for Plasma Physics (submittedVersion)
Funders
U.S. Public Health Service (64736)
Topics
  • 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
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords
major depressive disorder, depression onset, risk factors, comorbidities, functional disability, panic attacks, specific phobia, social anxiety disorder, agoraphobia, panic disorder, generalized anxiety disorder, adolescents and young adults, transition from adolescence to young adulthood
MeSH terms
Adolescent, Adult, Agoraphobia, Anxiety Disorders, Depressive Disorder, Female, Humans, Longitudinal Studies, Male, Phobic Disorders, Prognosis, Prospective Studies, Psychiatric Status Rating Scales, Risk Factors, Severity of Illness Index, Comorbidity, Panic Disorder, Diagnostic and Statistical Manual of Mental Disorders

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