Factors associated with anxiety disorder comorbidity

• DOI: 10.1016/j.jad.2022.11.051
• Publication Date: 2022-11-26T02:20:21Z
• Authors: Molly R. Davies; Kiran Glen; Jessica Mundy; Abigail R. ter Kuile; Brett N. Adey; Chérie Armour; Elham Assary; Jonathan R.I. Col...; Kimberley A. Gold...; Colette R. Hirsch; Matthew Hotopf; Christopher Hübel; Ian R. Jones; Gursharan Kalsi; Georgina Krebs; Andrew M. McIntosh; Geneviève Morneau...; Alicia J. Peel; Kirstin L. Purves; Sang Hyuck Lee; Megan Skelton; Daniel J. Smith; David Veale; James T.R. Walters; Katherine S. Young; Johan Zvrskovec; Gerome Breen; Thalia C. Eley
• Keywords: Depressive disorders; Depressive Disorder, Major; 150; 610; Comorbidity; Depressive Disorder, Major/diagnosis; Anxiety Disorders; Article; Affective disorders; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Polygenic risk score; Anxiety Disorders/diagnosis; Humans; Genetic Predisposition to Disease; Anxiety disorders; Retrospective Studies

Anxiety and depressive disorders often co-occur and the order of their emergence may be associated with different clinical outcomes. However, minimal research has been conducted on anxiety-anxiety comorbidity. This study examined factors associated with anxiety comorbidity and anxiety-MDD temporal sequence.Online, self-report data were collected from the UK-based GLAD and COPING NBR cohorts (N = 38,775). Logistic regression analyses compared differences in sociodemographic, trauma, and clinical factors between single anxiety, anxiety-anxiety comorbidity, anxiety-MDD (major depressive disorder) comorbidity, and MDD-only. Additionally, anxiety-first and MDD-first anxiety-MDD were compared. Differences in familial risk were assessed in those participants with self-reported family history or genotype data.Anxiety-anxiety and anxiety-MDD had higher rates of self-reported anxiety or depressive disorder diagnoses, younger age of onset, and higher recurrence than single anxiety. Anxiety-MDD displayed greater clinical severity/complexity than MDD only. Anxiety-anxiety had more severe current anxiety symptoms, less severe current depressive symptoms, and reduced likelihood of self-reporting an anxiety/depressive disorder diagnosis than anxiety-MDD. Anxiety-first anxiety-MDD had a younger age of onset, more severe anxiety symptoms, and less likelihood of self-reporting a diagnosis than MDD-first. Minimal differences in familial risk were found.Self-report, retrospective measures may introduce recall bias. The familial risk analyses were likely underpowered.Anxiety-anxiety comorbidity displayed a similarly severe and complex profile of symptoms as anxiety-MDD but distinct features. For anxiety-MDD, first-onset anxiety had an earlier age of onset and greater severity than MDD-first. Anxiety disorders and comorbidity warrant further investigation and attention in research and practice.