Co-morbid major depression and generalized anxiety disorders in the National Comborbity Survey follow-up
Co-morbid major depression and generalized anxiety disorders in the National Comborbity Survey follow-up
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DOI：
10.1017/s0033291707002012
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发表时间：
2008-03-01
影响因子：
6.9
通讯作者：
Yonkers, K. A.
中科院分区：
文献类型：
--
作者：
Kessler, R. C.;Gruber, M.;Yonkers, K. A.
背景虽然广泛性焦虑症（GAD）和重度抑郁发作（MDE）被认为是高度共病，很少有前瞻性研究已经检查这两种疾病是否预测随后的第一次发作或持续的其他或其他预测因素解释GAD和MDE. Method之间的时滞关联的程度。数据进行了分析，从全国代表性的两波面板样本的5001名受访者参加了1990-1992年全国科摩罗调查（NCS）和2001-2003年NCS的后续调查。两项调查均评估了GAD和MDE。基线NCS还评估了三组风险因素：儿童期逆境，父母精神物质障碍史和受访者的个性。基线MDE显著预测随后的GAD发作，但不持久。基线GAD显著预测随后MDE的发作和持续性。每一种疾病与另一种疾病的随后发作的关联随着时间的推移而减弱，但在发病后的十多年内仍然显着。危险因素预测发病多于持续。有意义的变化被发现的强度和一致性之间的关联危险因素和这两种疾病。风险因素的控制并没有实质性地减少疾病之间的净交叉滞后关联。GAD和MDE的危险因素存在差异，这与以下观点相悖：这两种疾病仅仅是单一内在综合征的不同表现，或者GAD仅仅是MDE的前驱症状、残留或严重程度标志物。
Background. Although generalized anxiety disorder (GAD) and major depressive episode (MDE) are known to be highly co-morbid, little prospective research has examined whether these two disorders predict the subsequent first onset or persistence of the other or the extent to which other predictors explain the time-lagged associations between GAD and MDE.Method. Data were analyzed from the nationally representative two-wave panel sample of 5001 respondents who participated in the 1990-1992 National Comorbidity Survey (NCS) and the 2001-2003 NCS follow-up survey. Both surveys assessed GAD and MDE. The baseline NCS also assessed three sets of risk factors that are considered here: childhood adversities, parental history of mental-substance disorders, and respondent personality.Results. Baseline MDE significantly predicted subsequent GAD onset but not persistence. Baseline GAD significantly predicted subsequent MDE onset and persistence. The associations of each disorder with the subsequent onset of the other attenuated with time since onset of the temporally primary disorder, but remained significant for over a decade after this onset. The risk factors predicted onset more than persistence. Meaningful variation was found in the strength and consistency of associations between risk factors and the two disorders. Controls for risk factors did not substantially reduce the net cross-lagged associations of the disorders with each other.Conclusions. The existence of differences in risk factors for GAD and MDE argues against the view that the two disorders are merely different manifestations of a single underlying internalizing syndrome or that GAD is merely a prodrome, residual, or severity marker of MDE.