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Related Experiment Videos

Anxiety secondary to depression.

W Coryell1

  • 1University of Iowa College of Medicine, Iowa City.

The Psychiatric Clinics of North America
|December 1, 1990
PubMed
Summary

Affective and anxiety disorders are fundamentally separate, with panic attacks indicating more severe depression and distinct treatment responses. Subdividing comorbid conditions by primary illness shows modest success, requiring further research.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Behavioral Science

Background:

  • Familial transmission, twin concordance, and epidemiologic patterns support separating affective and anxiety disorders.
  • Diagnostic stability on follow-up further validates the distinct nature of these conditions.
  • Subdividing comorbid conditions based on the presumed primary illness is a logical, though modestly evidenced, approach.

Purpose of the Study:

  • To explore the implications of separating affective and anxiety disorders.
  • To investigate the practical utility of temporal sequencing in defining primary illness in comorbid conditions.
  • To examine how panic attacks, obsessions, compulsions, and phobias relate to depressive episodes.

Main Methods:

  • Review of existing literature on familial transmission, twin concordance, and epidemiologic patterns.
  • Analysis of diagnostic stability and follow-up data.
  • Examination of clinical observations regarding panic attacks, obsessions, compulsions, and phobias in relation to depression.

Main Results:

  • Panic attacks are associated with more severe depression and poorer prognosis.
  • Obsessions and compulsions emerging during depressive episodes differ from autonomous ones.
  • Depression may precipitate specific types of phobias.
  • Panic attacks may predict differential responses to antidepressants (MAOIs vs. tricyclics).

Conclusions:

  • The separation of affective and anxiety disorders is strongly supported by multiple lines of evidence.
  • While temporal sequencing is conventional for subdividing comorbid conditions, its success is modest.
  • Clinical features like panic attacks offer valuable prognostic and treatment-predictive information.
  • Further research is needed due to the limited literature currently available.

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