Comorbidity and boundaries of affective disorders with anxiety disorders and substance misuse: Results of an international task force

被引:158
作者
Merikangas, KR
Angst, J
Eaton, W
Canino, G
RubioStipec, M
Wacker, H
Wittchen, HU
Andrade, L
Essau, C
Whitaker, A
Kraemer, H
Robins, LN
Kupfer, DJ
机构
[1] UNIV ZURICH,CH-8029 ZURICH,SWITZERLAND
[2] JOHNS HOPKINS UNIV,BALTIMORE,MD 21205
[3] UNIV PUERTO RICO,MED CTR,RIO PIEDRAS,PR 00935
[4] UNIV BASEL,PSYCHIAT KLIN,CH-4031 BASEL,SWITZERLAND
[5] MAX PLANCK INST PSYCHIAT,D-800 MUNICH 40,GERMANY
[6] HOSP CLIN SAO PAULO,INST PSIQUIATRIA,BR-8091 SAO PAULO,BRAZIL
[7] UNIV BREMEN,KINDERAMBULANZ,D-28359 BREMEN,GERMANY
[8] STANFORD UNIV,DEPT PSYCHIAT & BEHAV SCI,PALO ALTO,CA 94305
[9] WASHINGTON UNIV,SCH MED,ST LOUIS,MO 63110
[10] UNIV PITTSBURGH,SCH MED,PITTSBURGH,PA 15213
关键词
D O I
10.1192/S0007125000298425
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Associations between affective disorders,anxiety disorders, and substance use disorders were examined in epidemiological studies conducted in Germany, Switzerland, Puerto Rico, and the mainland US. There was a remarkable degree of similarity across studies in the magnitude and type of specific disorders associated with the affective disorders. Comorbidity with affective disorders was greater for the anxiety disorders than for substance misuse. Panic disorder was the subtype of anxiety that was most highly comorbid with depression. Social phobia was the specific phobic type with the strongest association with the affective disorders. The magnitude of associations between substance misuse and affective disorders generally was quite low and less consistent across sites. No major differences were found in the patterns of comorbidity by gender or age group, affective subtype or prevalence period. The onset of anxiety disorders generally preceded that of depression, whereas alcohol misuse was equally likely to pre- or post-date ?he onset of affective disorders. Finally, comorbidity was associated with an elevation in treatment rates across all sites, confirming Berkson's paradox on an international level.
引用
收藏
页码:58 / 67
页数:10
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