MIDAS Project Publication Abstracts
Zimmerman, M., Chelminski, I., & McDermut,
W. Major depressive disorder and Axis I diagnostic comorbidity. Journal of Clinical Psychiatry, 2002, 63, 187-193.
Background: Recognition of comorbid conditions in patients
presenting for the treatment of depression is clinically important
because the presence of other disorders can influence treatment
planning. In the present report we examined the frequency of diagnostic
comorbidity in psychiatric outpatients presenting for treatment
of nonbipolar major depressive disorder (MDD), and patients' desire
for treatment for the comorbid disorders.
Methods: Four hundred and seventy-nine psychiatric outpatients
with DSM-IV nonbipolar MDD were evaluated with a modified version
of the Structured Clinical Interview for DSM-IV (SCID).
Results: Excluding nicotine dependence, at the time of the
evaluation 64.1% (n=307) of the patients met criteria for at least
one of the 23 specific Axis I disorders, and more than one-third
(36.7%, n=176) had two or more disorders. Anxiety disorders, as
a group, were the most frequent current comorbid disorder (56.8%),
and social phobia was the most frequent individual disorder. Including
subthreshold conditions, the percentage of patients with at least
one disorder increased to 73.5%. When the scope of assessment was
expanded to include nicotine dependence, then nicotine dependence
was the most frequent lifetime individual disorder (38.2%), and
the second most frequent current disorder (27.3%). There was considerable
variability amongst the disorders regarding desire for treatment
of the comorbid condition.
Conclusions: The majority of nonbipolar depressed patients
have a current comorbid disorder, especially an anxiety disorder,
though the actual rate of comorbidity depends on the breadth of
the assessment.
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