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Merikangas, K. R. et al. Longitudinal trajectories of depression and anxiety in a prospective community study: the Zurich Cohort Study. Arch. Gen. Psychiatry 60, 993-1000

Mood and Anxiety Disorders Program, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
Archives of General Psychiatry (Impact Factor: 13.75). 11/2003; 60(10):993-1000. DOI: 10.1001/archpsyc.60.9.993
Source: PubMed

ABSTRACT The dearth of long-term follow-up studies of community-based samples and differences in methodology in existing studies highlight the need for research designed to examine the stability, comorbidity, and diagnostic thresholds of depression and anxiety in the community.
Prospective study of a community-based cohort aged 19 and 20 years from the canton of Zurich, Switzerland. Semistructured diagnostic interviews were administered by clinically experienced interviewers at 5 assessment points during a 15-year period. The format of the interview permitted assessment of major mental disorders at both the diagnostic and subthreshold levels.
Comorbid anxiety and depression tended to be far more persistent than either syndrome alone. Individuals with anxiety states alone tended to develop either depression alone or comorbid anxiety and depression as they progressed through adulthood. In contrast, depression alone and depression comorbid with anxiety tended to be more stable than anxiety alone over time. The patterns of stability were similar for subthreshold- and threshold-level disorders.
These findings have important implications for classification and treatment of affective disorders. The greater stability of comorbid anxiety and depression than either disorder alone illustrates the importance of further investigation of comorbid states compared with noncomorbid states in etiologic and treatment research. The persistence of subthreshold-level depression and anxiety from early to mid adulthood also suggests the importance of characterizing the continuum of expression of depression and anxiety rather than adhering to strict diagnostic thresholds.

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    • "However, the absence of sex differences in these pathways is consistent with the recent study by McLaughlin and King (2015), which did not find sex differences in anxiety or depressive symptom trajectories or their relationship to each other over time. One notable similarity in the present study is the examination of social anxiety and depression at the symptom-level rather than the diagnostic level, which may account for the difference from prior research (Merikangas et al. 2003). Further, this is the first study to evaluate racial differences in the temporal relationship between social anxiety and depressive symptoms. "
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    • "However, previous research has demonstrated that contemporary diagnostic systems fail to cover depressive and anxiety states among those who do not meet duration or impairment criteria yet exhibit recurrence, subjective distress and have a history of treatment [2] [3]. The importance of this limitation is further reinforced by general population evidence on the potential impact and stability over time of subthreshold-level depression and anxiety [3] [31] [50] [69]. As a result, general practitioners in the UK and US are now advised to also recognize persistent subthreshold forms of depression [20] [52] [56], for which primary care management may be effective [14] [33]. "
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    • "Angsterkrankungen haben häufig einen chronischen Verlauf (Merikangas et al., 2003), zudem entwickeln Patienten , die an einer Angsterkrankung leiden, oft komorbide Störungen wie z. B. Depressionen (Merikangas et al., 2003). Eine Angsterkrankung ist häufig mit einer signifikanten Einschränkung von Lebensqualität und sozialer und beruflicher Funktionsfähigkeit verbunden (Olatunji, Cisler & Tolin, 2007; Rufer, Moergeli, Moritz, Drabe & Weidt, 2014). "
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