Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder

Abstract

The comorbidity of major depressive disorder (MDD) and generalized anxiety disorder (GAD) is common and often predicts poorer outcomes than either disorder alone. This study aimed to examine the prevalence of comorbid GAD and its association with quality of life (QOL) among MDD patients. A total of 1225 psychiatric outpatients were screened using the Hospital Anxiety and Depression Scale (HADS). Those who scored ≥8 on the HADS were interviewed using DSM-IV criteria by two senior psychiatrists. Patients diagnosed with MDD were further assessed using the 9-item Patient Health Questionnaire, Social Support Rating Scale, Pittsburgh Sleep Quality Index, and World Health Organization QOL Scale, brief version (WHOQOL-BREF). Ultimately, 667 patients were diagnosed with MDD, of 71.7% of whom had GAD. Compared to those with MDD alone, comorbid patients had lower scores on the physical (38.64 ± 10.35 vs.36.54 ± 12.32, P = 0.026) and psychological (35.54 ± 12.98 vs. 30.61 ± 14.66, P < 0.001) domains of the WHOQOL-BREF. The association between comorbid GAD and poor QOL on the two domains remained statistically significant in the multiple linear regression (unstandardized coefficients: −1.97 and −4.65, P < 0.001). In conclusion, the prevalence of comorbid GAD in MDD patients is high, and co-occurring GAD may exacerbate impaired physical and psychological QOL in Chinese MDD patients.

Well-being in major depression and social phobia with and without comorbidity

“…Although there is research in the field of quality of life, a construct that is sharing similarities with well-being, there is no research so far in terms of differences in well-being in adults with and without anxiety-depressive comorbidities. Our findings are consistent with those studies reporting lower quality of life ( Cavicchioli et al, 2018 , Norberg et al, 2008 , Zhou et al, 2017 ) in individuals with comorbid disorders, perhaps due to the higher symptom burden, compared to individuals no comorbidity. For instance, a study examining associations of anxiety-depression comorbidity and quality of life found that comorbidity to depression in anxiety disorders is linked to lower quality of life ( Norberg et al, 2008 ).…”

“…Perhaps, in clinical practice well-being should be addressed more in individuals with comorbidity. As for the depression-anxiety comorbidity, research to date is mainly on quality of life ( Rapaport et al, 2005 , Zhou et al, 2017 ) and there is little research comparing quality of life in individuals with depression-anxiety comorbidity to individuals with no comorbidity ( Johansson et al, 2013 , Norberg et al, 2008 ). These studies consistently showed lower quality of life in individuals with depression-anxiety comorbidity when compared to individuals without comorbidity.…”

Brain mechanisms of insomnia: new perspectives on causes and consequences

“…While this is generally recognized for major depressive disorder (35), it may hold for other disorders of mood or distress regulation as well. Zhou et al (451) found that four out of five of GAD patients have comorbid Insomnia Disorder. Sleep studies have also shown that these subjective complaints have their objective counterpart in sleep EEG recordings.…”

The Role of the Eukaryotic Translation Initiation Factor 4E (eIF4E) in Neuropsychiatric Disorders

“…Depressive and anxiety disorders are often comorbid and represent the most common causes of disability worldwide ( Zhou et al, 2017 ). In addition, these psychiatric conditions are commonly present in people suffering from ASDs ( Magnuson and Constantino, 2011 ).…”