Anxiety and depression share a long, close history in psychiatric nosology and treatment. The anxiety disorders, individually and as a group, exhibit remarkably high rates of comorbidity with each other and with major depression. Analyses done in large-scale epidemiologic surveys have identified major patterns of phenomenological overlap between these conditions. Researchers have tested hypotheses of shared genetic etiologies as a potential basis of this relationship. In general, available family studies have found mixed evidence for co-aggregation of anxiety and depressive disorders, while twin studies more definitively indicate that shared genetic risk factors largely account for this comorbidity. Some of this appears to be accounted for by genetic variation in personality traits that broadly predispose to anxiety and depression. Molecular genetic studies of these conditions, though too early to draw firm conclusions, thus far provide tentative support for specific genetic loci that may generally influence susceptibility across the anxiety-depressive spectrum.
"A degree of clustering was introduced to account for patterns of shared liabilities between individual disorders above and beyond those introduced by life history variation. Specifically, MDD and GAD were part of a depression/GAD cluster (see Hettema, 2008; Lahey et al., 2011), whereas schizophrenia and mania were part of a psychosis cluster (see Cosgrove & Suppes, 2013; Crespi, Stead, & Elliot, 2010; International Schizophrenia Consortium, 2009). In the life history model, the autogenous subtype of OCD (but not the reactive subtype) is regarded as a functional correlate of the psychosis spectrum (Del Giudice, 2014a); to reflect this assumption, OCD was included in two overlapping clusters—the psychosis cluster and a separate OCD cluster. "
"We present robust findings of a gender–age interaction with a male preponderance before puberty and a female preponderance after. The gender–age interaction is present for both depressive disorders and anxiety disorders, supporting existing theories of an affective-anxious spectrum (Hudson et al. 2003; Middeldorp et al. 2005; Weissman et al. 2005; Hettema, 2008; Gardner & Boles, 2011). We hypothesize that males have a generalized prepubertal vulnerability towards a broader spectrum of mental disorders, rather than just neurodevelopmental disorders. "
[Show abstract][Hide abstract] ABSTRACT: Background:
The post-pubertal association of female gender with emotional disorder is a robust finding. However, studies exploring the association of gender and emotional disorders before puberty are few and present diverging results. The aim of this study was to present gender-specific incidence rates of emotional disorders throughout childhood.
This is a population-based cohort study of 907,806 Danish 3- to 18-year-olds. The outcome was assignment of an emotional disorder diagnosis based on in-patient and out-patient data from The Danish Psychiatric Central Register. Outcome measures were incidence rates and cumulative incidences for unipolar depressive disorder (ICD-10: F32-F33), anxiety disorders (ICD-10: F40-F42), and emotional disorders with onset specific to childhood (ICD-10: F93).
Pre-pubertal incidence rates for depressive and anxiety disorders were higher for boys than girls. At age 12 years the pattern reversed. The cumulative incidence for any emotional disorder (F32-F33, F40-F42, F93) on the 11th birthday was 0.52% (95% CI 0.50-0.55) for boys and 0.31% (95% CI 0.29-0.33) for girls. On the 19th birthday cumulative incidence was 2.33% (95% CI 2.24-2.43) for boys and 3.77% (95% CI 3.64-3.90) for girls. The pre-pubertal male preponderance was also significant for depressive disorders (F32-F33, p = 0.00144) and anxiety disorders (F40-F42, F93, p < 0.00001) separately.
Emotional disorders seem to display a male preponderance before the age of 12 years and a female preponderance thereafter. Studies exploring this gender-age interaction are needed. Still, the results question the general assumption that females throughout the lifespan are more at risk for emotional disorders than males.
Psychological Medicine 08/2014; 45(04):1-11. DOI:10.1017/S0033291714001901 · 5.94 Impact Factor
"Furthermore, broad genetic associations are in line with high rates of co-occurrence between anxiety and depression (Seligman & Ollendick, 1998) and between cognitive risk factors for both sets of symptoms (Zavos et al. 2010). Evidence for shared genetic effects has implications for molecular genetic studies, supporting the persuasive argument that including cases with anxiety and depression disorders would lead to increasing power to detect shared susceptibility loci (Hettema, 2008). Conversely, evidence for phenotypic specificity in associations between anxiety sensitivity, anxiety and depression and unique environmental influences acting on these symptoms has clinical implications for therapeutic interventions. "
[Show abstract][Hide abstract] ABSTRACT: Background:
The classification of anxiety and depressive disorders has long been debated and has important clinical implications. The present study combined a genetically sensitive design and multiple time points to investigate cognitive content specificity in anxiety and depressive disorder symptoms across anxiety sensitivity dimensions, a cognitive distortion implicated in both disorders.
Phenotypic and genetic correlations between anxiety sensitivity dimensions, anxiety and depressive disorder symptoms were examined at five waves of data collection within childhood, adolescence and early adulthood in two representative twin studies (n pairs = 300 and 1372).
The physical concerns dimension of anxiety sensitivity (fear of bodily symptoms) was significantly associated with anxiety but not depression at all waves. Genetic influences on physical concerns overlapped substantially more with anxiety than depression. Conversely, mental concerns (worry regarding cognitive control) were phenotypically more strongly associated with depression than anxiety. Social concerns (fear of publicly observable symptoms of anxiety) were associated with both anxiety and depression in adolescence. Genetic influences on mental and social concerns were shared to a similar extent with both anxiety and depression.
Phenotypic patterns of cognitive specificity and broader genetic associations between anxiety sensitivity dimensions, anxiety and depressive disorder symptoms were similar at all waves. Both disorder-specific and shared cognitive concerns were identified, suggesting it is appropriate to classify anxiety and depression as distinct but related disorders and confirming the clinical perspective that cognitive therapy is most likely to benefit by targeting cognitive concerns relating specifically to the individual's presenting symptoms across development.
Psychological Medicine 04/2014; 44(16):1-12. DOI:10.1017/S0033291714000828 · 5.94 Impact Factor
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