Lifetime panic–depression comorbidity in the National Comorbidity Survey

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Abstract
Background: Most prior studies of panic-depression comorbidity have been limited methodologically by use of small clinical samples and incomplete analyses.Aims: General population data were used to study the association of lifetime and recent (12 months) panic–depression comorbidity with symptom severity, impairment, course and help-seeking in the National Comorbidity Survey (NCS).Method: The NCS is a nationally representative survey of the prevalences and correlates of major DSM–III–R disorders in the US household population.Results: Strong lifetime and current comorbidity were found between panic and depression. Comorbidity was associated with greater symptom severity, persistence, role impairment, suicidality and help-seeking, with many findings persisting after controlling for additional comorbid diagnoses. Findings did not differ according to which disorder was chronologically primary.Conclusions: Both lifetime and current panic–depression comorbidity are markers for more severe, persistent and disabling illness. Neither additional comorbid diagnoses nor the primary–secondary distinction were important moderators of these associations.