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Depressive episodes–evidence for a causal role of primary anxiety disorders?

Published online by Cambridge University Press:  16 April 2020

Hans-Ulrich Wittchen ,
Katja Beesdo ,
Antje Bittner  and
Renee D. Goodwin
Hans-Ulrich Wittchen*
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Dresden University of Technology, Chemnitzerstrasse 46, 01187Dresden, Germany Max Planck Institute of Psychiatry, Munich, Germany
Katja Beesdo
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Dresden University of Technology, Chemnitzerstrasse 46, 01187Dresden, Germany
Antje Bittner
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Dresden University of Technology, Chemnitzerstrasse 46, 01187Dresden, Germany
Renee D. Goodwin
Affiliation:
Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA
*
*Corresponding author. [email protected] (H.-U.Wittchen).
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Abstract

Anxiety and depressive disorders are common mental disorders in general population, imposing tremendous burden on both affected persons and society. Moreover, comorbidity between anxiety and depressive conditions is high, leading to substantial disability and functional impairment. Findings consistently suggest that anxiety disorders are primary to depression in the majority of comorbid cases. Yet, the question of whether anxiety disorders are risk factors for depression, and potentially even causal risk factors for the first onset of depression, remains unresolved. Recent results have shown that anxiety disorders increase the risk for subsequent depression, and also affect the course of depression, resulting in a poorer prognosis. Further, some results suggest a dose–response-relationship in revealing that a higher number of anxiety disorders and more severe impairment associated with anxiety disorders additionally increase the risk for subsequent depression. The goal of this paper is to review recent literature, summarize implications of previous findings, and suggest directions for future research regarding preventive and intervention strategies.

Keywords

AnxietyDepressionComorbidityRisk factor
Type
Original article
Information
European Psychiatry , Volume 18 , Issue 8 , December 2003 , pp. 384 - 393
Copyright
Copyright © 2003 European Psychiatric Association

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