DIAGNOSTIC OVERLAP OF GENERALIZED ANXIETY DISORDER AND MAJOR DEPRESSIVE DISORDER IN A PRIMARY CARE SAMPLE
Article first published online: 26 NOV 2012
© 2012 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 29, Issue 12, pages 1065–1071, December 2012
How to Cite
Zbozinek, T. D., Rose, R. D., Wolitzky-Taylor, K. B., Sherbourne, C., Sullivan, G., Stein, M. B., Roy-Byrne, P. P. and Craske, M. G. (2012), DIAGNOSTIC OVERLAP OF GENERALIZED ANXIETY DISORDER AND MAJOR DEPRESSIVE DISORDER IN A PRIMARY CARE SAMPLE. Depress. Anxiety, 29: 1065–1071. doi: 10.1002/da.22026
- Issue published online: 3 DEC 2012
- Article first published online: 26 NOV 2012
- Manuscript Accepted: 18 OCT 2012
- Manuscript Revised: 28 SEP 2012
- Manuscript Received: 9 DEC 2011
- generalized anxiety disorder;
- major depressive disorder;
- primary care;
- diagnostic criteria
Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are highly comorbid. A possible explanation is that they share four symptoms according to the Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition—Text Revision (DSM-IV-TR). The present study addressed the symptom overlap of people meeting DSM-IV-TR diagnostic criteria for GAD, MDD, or both to investigate whether comorbidity might be explained by overlapping diagnostic criteria.
Participants (N = 1,218) were enrolled in the Coordinated Anxiety Learning and Management study (a randomized effectiveness clinical trial in primary care). Hypotheses were (1) the comorbid GAD/MDD group endorses the overlapping symptoms more than the nonoverlapping symptoms, and (2) the comorbid GAD/MDD group endorses the overlapping symptoms more than GAD only or MDD only groups, whereas differences would not occur for nonoverlapping symptoms.
The overlapping GAD/MDD symptoms were endorsed more by the comorbid group than the MDD group but not the GAD group when covarying for total symptom endorsement. Similarly, the comorbid group endorsed the overlapping symptoms more than the nonoverlapping symptoms and did not endorse the nonoverlapping symptoms more than the GAD or MDD groups when covarying for total symptom endorsement.
The results suggest that comorbidity of GAD and MDD is strongly influenced by diagnostic overlap. Results are discussed in terms of errors of diagnostic criteria, as well as models of shared psychopathology that account for diagnostic criteria overlap.