The 7‐year course of depression and anxiety in the general population

Rhebergen, Didi; Batelaan, Neeltje M.; Graaf, Ron de; Nolen, Willem A.; Spijker, Jan; Beekman, Aartjan T.F.; Penninx, Brenda W. J. H.

doi:10.1111/j.1600-0447.2011.01677.x

Cited by 105 publications

(76 citation statements)

References 35 publications

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“…First, we investigate the average courses over time, to gain insight into the average change or stability in positive mental health and psychopathological symptoms during the course of nine months. We hypothesize that, on average, both positive mental health and psychopathology show stability over time, in line with studies on emotional well-being (Diener et al, 2006;Eid & Diener, 2004;Fujita & Diener, 2005) and psychopathology (e.g., Merikangas et al, 2003;Rhebergen et al, 2011), and in accordance with the relatively short time-span and the general and representative sample of adults. We expect the levels and courses of positive mental health and psychopathology to be negatively correlated, in line with earlier studies (e.g., .…”

Section: Introductionsupporting

confidence: 84%

“…Studies on psychopathology show similar findings. Psychopathology such as depression and anxiety is relatively stable, mainly when comorbidity is present (e.g., Merikangas et al, 2003;Rhebergen et al, 2011). Although these findings indicate that emotional well-being and psychopathology are relatively stable, yet amenable for change, there are no studies that investigate the longitudinal course of positive mental health by including emotional, psychological, as well as social well-being, nor studies that directly compare the longitudinal courses of positive mental health and psychopathology.…”

Section: Introductionmentioning

confidence: 99%

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Positive mental health : measurement, relevance and implications

Lamers¹

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Section: Introductionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Positive mental health : measurement, relevance and implications

Lamers¹

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“…Anxiety and depression are highly comorbid at both subthreshold and threshold levels (Das-Munshi et al, 2008;De Graaf et al, 2002;Kessler et al, 2005Kessler et al, , 1994Piccinelli et al, 1999;Preisig et al, 2001;Spijker et al, 2010), anxiety disorders and depressive disorders share a genetic vulnerability (Hettema et al, 2006), and diagnostic conversions occur over time from anxiety disorders to depressive disorders and vice versa (Hagnell and Grasbeck, 1990;Merikangas et al, 2003;Rhebergen et al, 2011). These findings have raised the fundamental question of whether it is justified to regard anxiety and depressive disorders as different disease concepts.…”

Section: Inconsistency In Nomenclature Between Subthreshold and Thresmentioning

confidence: 99%

Mixed Anxiety Depression Should Not Be Included in DSM-5

Batelaan¹,

Spijker²,

Graaf³

et al. 2012

The Journal of Nervous and Mental Disease

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Subthreshold anxiety and subthreshold depressive symptoms often co-occur in the general population and in primary care. Based on their associated significant distress and impairment, a psychiatric classification seems justified. To enable classification, mixed anxiety depression (MAD) has been proposed as a new diagnostic category in DSM-5. In this report, we discuss arguments against the classification of MAD. More research is needed before reifying a new category we know so little about. Moreover, we argue that in patients with MAD symptoms and a history of an anxiety or depressive disorder, symptoms should be labeled as part of the course trajectories of these disorders, rather than calling it a different diagnostic entity. In patients with incident co-occurring subthreshold anxiety and subthreshold depression, subthreshold categories of both anxiety and depression could be classified to maintain a consistent classification system at both threshold and subthreshold levels.

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“…Finally, we explored the characteristics of each identified class and examined putative predictors of class membership, and hence course trajectory. In previous studies, sociodemographics, co-morbid anxiety disorders (Hayden & Klein, 2001), age of onset of depressive symptoms (Klein et al 1999 ;Angst et al 2009), childhood adversity (Hayden & Klein, 2001 ;Rhebergen et al 2011), somatic co-morbidity (Angst et al 2009), neuroticism (Hayden & Klein, 2001 ;Rhebergen et al 2011) and a family history of depression (Klein et al 1999 ;Stoolmiller et al 2005 ;Olino et al 2010) have been demonstrated to predict course trajectories. However, some inconsistencies exist.…”

Section: Introductionmentioning

confidence: 99%

Course trajectories of unipolar depressive disorders identified by latent class growth analysis

et al. 2011

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Background. Current classification of unipolar depression reflects the idea that prognosis is essential. However, do DSM categories of major depressive disorder (MDD), dysthymic disorder (Dysth) and double depression (DD=MDD+Dysth) indeed adequately represent clinically relevant course trajectories of unipolar depression ? Our aim was to test DSM categories (MDD, Dysth and DD) in comparison with empirically derived prognostic categories, using a prospectively followed cohort of depressed patients.Method. A large sample (n=804) of out-patients with unipolar depression were derived from a prospective cohort study, the Netherlands Study of Depression and Anxiety (NESDA). Using latent class growth analysis (LCGA), empirically derived 2-year course trajectories were constructed. These were compared with DSM diagnoses and a wider set of putative predictors for class membership.Results. Five course trajectories were identified, ranging from mild severity and rapid remission to high severity and chronic course trajectory. Contrary to expectations, more than 50 % of Dysth and DD were allocated to classes with favorable course trajectories, suggesting that current DSM categories do not adequately represent course trajectories. The class with the most favorable course trajectory differed on several characteristics from other classes (younger age, more females, less childhood adversity, less somatic illnesses, lower neuroticism, higher extraversion). Older age, earlier age of onset and lower extraversion predicted poorest course trajectory.Conclusions. MDD, Dysth and DD did not adequately match empirically derived course trajectories for unipolar depression. For the future classification of unipolar depression, it may be wise to retain the larger, heterogeneous category of unipolar depression, adopting cross-cutting dimensions of severity and duration to further characterize patients.

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The 7‐year course of depression and anxiety in the general population

Abstract: Course trajectories were more favorable than expected, although comorbidity resulted in poorer course. Neuroticism, physical functioning, and childhood adversity predicted an unfavorable course.

Cited by 105 publications

References 35 publications

Positive mental health : measurement, relevance and implications

Positive mental health : measurement, relevance and implications

Mixed Anxiety Depression Should Not Be Included in DSM-5

Course trajectories of unipolar depressive disorders identified by latent class growth analysis

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