Anxiety Comorbidity in Referred Children and Adolescents with Dysthymic Disorder

Abstract

Anxiety disorders are common in patients with depressive disorders. This preliminary study investigated some clinical correlates of comorbidity between dysthymic disorder (DD) and generalized anxiety disorder (GAD) in a clinically referred sample of children and adolescents. After psychiatric evaluation, including a diagnostic clinical interview (DICA-R), 51 patients (25 males and 26 females, mean age 13.1 years) with an index diagnosis of DD associated with GAD were compared with 22 patients (13 males and 9 females, mean age 12.9 years) diagnosed as having pure DD. The comparison between subjects (DD with or without GAD) regarding the number of depressive symptoms did not show a significant main effect of group. Suicidal ideation was significantly more frequent in the group with comorbid GAD. Internalizing disorders were more frequent in the group of DD with GAD, while externalizing disorders were more frequent in the group without GAD. Functional impairment, assessed with the Children’s Global Assessment Scale, did not show significant differences between the two groups. Data are discussed in the light of conceptualizations about the relationship between chronic anxiety and depressive disorders.

Characteristics of Internalizing and Externalizing Disorders in Medication-Naïve, Clinically Referred Children with Attention Deficit Hyperactivity Disorder, Combined Type and Dysthymic Disorder

“…This is consistent with rates reported in three previous studies [21,23,24], but higher than the rates of 17% and 30% in more recent reports [50,51]. rule violation and pathological lying) [51,52] than those with one diagnosis only (pure DD or pure major depressive disorder). rule violation and pathological lying) [51,52] than those with one diagnosis only (pure DD or pure major depressive disorder).…”

Self-report measures in the study of comorbidity in children and adolescents with social phobia: Research and clinical utility

“…Chorpita et al's finding supports our finding that the CDI's accuracy to detect an additional diagnosis of GAD in children with SOP was nearly significant. Second, several investigators have found that GAD is in fact highly comorbid with depression in children and adolescents (e.g., Chavira, Stein, Bailey, & Stein, 2004;Curry et al, 2004;Masi et al, 2000;Masi, Mucci, Favilla, & Millepiedi, 2001;Masi, Mucci, Favilla, Romano, & Poli, 1999;Verduin & Kendall, 2003). Thus, the higher symptoms of depression seen in the comorbid SOP-GAD group in comparison to the SOP-only group, despite a lack of depressive disorder diagnoses, may be partly explained by the secondary diagnosis of GAD.…”

Comorbidity of anxiety and depression in children and adolescents: 20 years after.

“…In a recent study (O’Neil-Rodriguez & Kendall, 2012), 58% of youth diagnosed with an anxiety disorder reported suicidal ideation. Some studies have uncovered an association between anxiety and suicidality independent of depression (Boden, Fergusson, & Horwood, 2007; Foley, Goldston, Costello, & Angold, 2006; Ghaziuddin, King, Naylor, & Ghaziuddin, 2000; Goldston et al, 2009; Liu et al, 2006; Masi, Mucci, et al, 2001; O’Neil, Puleo, Benjamin, Podell, & Kendall, 2012; O’Neil-Rodriguez & Kendall, 2012) whereas a few others have not (Barbe et al, 2005; Esposito & Clum, 2002; Greene, Chorpita, & Aukahi, 2009; Ryan et al, 1987; Strauss et al, 2000). It may be that emotion dysregulation (Southam-Gerow & Kendall, 2000; Garber, Braafladt, & Weiss, 1995; Keenan, Hipwell, Hinze, & Babinski, 2009; Silk, Steinberg, & Morris, 2003; Suveg, Hoffman, Zeman, & Thomassin, 2009) and distress tolerance (Ellis, Fischer, & Beevers, 2010; Huang, Szabó, & Han, 2009; Keough, Riccardi, Timpano, Mitchell, & Schmidt, 2010; Daughters et al, 2009) constructs related to both depression and anxiety, drive their associations with suicidality (Zlotnick, Donaldson, Spirito, & Pearlstein, 1997; Tamas et al, 2007; Nock & Mendes, 2008; Anestis, Bagge, Tulle, & Joiner, 2011).…”

“…One explanation has to do with severity of the disorder (e.g., in community versus hospitalized youth), type of anxiety disorder, and the operational definition of suicidality (O’Neil-Rodriguez & Kendall, 2012). Although few studies have been adequately powered to examine suicidality in relation to each individual anxiety disorder, studies have supported specific relationships with GAD (Foley et al, 2006; Goldston et al, 2009; Masi, Mucci et al, 2001) and SAD (Liu et al, 2006; Masi, Mucci et al, 2001). The operational definition of suicidality (e.g., ideation; intent; capability of acting on intent) is especially relevant.…”