Factors associated with anxiety disorder comorbidity

Molly R. Davies; Kiran Glen; Jessica Mundy; Abigail R. ter Kuile; Brett N. Adey; Chérie Armour; Elham Assary; Jonathan R.I. Coleman; Kimberley A. Goldsmith; Colette R. Hirsch; Matthew Hotopf; Christopher Hübel; Ian R. Jones; Gursharan Kalsi; Georgina Krebs; Andrew M. McIntosh; Geneviève Morneau-Vaillancourt; Alicia J. Peel; Kirstin L. Purves; Sang Hyuck Lee; Megan Skelton; Daniel J. Smith; David Veale; James T.R. Walters; Katherine S. Young; Johan Zvrskovec; Gerome Breen; Thalia C. Eley

doi:10.1016/j.jad.2022.11.051

Factors associated with anxiety disorder comorbidity

Molly R. Davies, Kiran Glen, Jessica Mundy, Abigail R. ter Kuile, Brett N. Adey, Chérie Armour, Elham Assary, Jonathan R.I. Coleman, Kimberley A. Goldsmith, Colette R. Hirsch, Matthew Hotopf, Christopher Hübel, Ian R. Jones, Gursharan Kalsi, Georgina Krebs, Andrew M. McIntosh, Geneviève Morneau-Vaillancourt, Alicia J. Peel, Kirstin L. Purves, Sang Hyuck LeeMegan Skelton, Daniel J. Smith, David Veale, James T.R. Walters, Katherine S. Young, Johan Zvrskovec, Gerome Breen, Thalia C. Eley

School of Psychology

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

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Abstract

Background
Anxiety and depressive disorders often co-occur and the order of their emergence may be associated with different clinical outcomes. However, minimal research has been conducted on anxiety-anxiety comorbidity. This study examined factors associated with anxiety comorbidity and anxiety-MDD temporal sequence.

Methods
Online, self-report data were collected from the UK-based GLAD and COPING NBR cohorts (N = 38,775). Logistic regression analyses compared differences in sociodemographic, trauma, and clinical factors between single anxiety, anxiety-anxiety comorbidity, anxiety-MDD (major depressive disorder) comorbidity, and MDD-only. Additionally, anxiety-first and MDD-first anxiety-MDD were compared. Differences in familial risk were assessed in those participants with self-reported family history or genotype data.

Results
Anxiety-anxiety and anxiety-MDD had higher rates of self-reported anxiety or depressive disorder diagnoses, younger age of onset, and higher recurrence than single anxiety. Anxiety-MDD displayed greater clinical severity/complexity than MDD only. Anxiety-anxiety had more severe current anxiety symptoms, less severe current depressive symptoms, and reduced likelihood of self-reporting an anxiety/depressive disorder diagnosis than anxiety-MDD. Anxiety-first anxiety-MDD had a younger age of onset, more severe anxiety symptoms, and less likelihood of self-reporting a diagnosis than MDD-first. Minimal differences in familial risk were found.

Limitations
Self-report, retrospective measures may introduce recall bias. The familial risk analyses were likely underpowered.

Conclusions
Anxiety-anxiety comorbidity displayed a similarly severe and complex profile of symptoms as anxiety-MDD but distinct features. For anxiety-MDD, first-onset anxiety had an earlier age of onset and greater severity than MDD-first. Anxiety disorders and comorbidity warrant further investigation and attention in research and practice.

Original language	English
Pages (from-to)	280-291
Number of pages	12
Journal	Journal of Affective Disorders
Volume	323
Early online date	02 Dec 2022
DOIs	https://doi.org/10.1016/j.jad.2022.11.051
Publication status	Published - 15 Feb 2023

Keywords

Affective disorders
Anxiety disorders
Comorbidity
Depressive disorders
Polygenic risk score

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10.1016/j.jad.2022.11.051Licence: CC BY

Factors associated with anxiety disorder comorbidity
Copyright 2022 the authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 1.42 MBLicence: CC BY

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Davies, M. R., Glen, K., Mundy, J., Kuile, A. R. T., Adey, B. N., Armour, C., Assary, E., Coleman, J. R. I., Goldsmith, K. A., Hirsch, C. R., Hotopf, M., Hübel, C., Jones, I. R., Kalsi, G., Krebs, G., McIntosh, A. M., Morneau-Vaillancourt, G., Peel, A. J., Purves, K. L., ... Eley, T. C. (2023). Factors associated with anxiety disorder comorbidity. Journal of Affective Disorders, 323, 280-291. https://doi.org/10.1016/j.jad.2022.11.051

@article{6d5716f060804aa3be5a2b5cc1a99837,

title = "Factors associated with anxiety disorder comorbidity",

abstract = "BackgroundAnxiety and depressive disorders often co-occur and the order of their emergence may be associated with different clinical outcomes. However, minimal research has been conducted on anxiety-anxiety comorbidity. This study examined factors associated with anxiety comorbidity and anxiety-MDD temporal sequence.MethodsOnline, self-report data were collected from the UK-based GLAD and COPING NBR cohorts (N = 38,775). Logistic regression analyses compared differences in sociodemographic, trauma, and clinical factors between single anxiety, anxiety-anxiety comorbidity, anxiety-MDD (major depressive disorder) comorbidity, and MDD-only. Additionally, anxiety-first and MDD-first anxiety-MDD were compared. Differences in familial risk were assessed in those participants with self-reported family history or genotype data.ResultsAnxiety-anxiety and anxiety-MDD had higher rates of self-reported anxiety or depressive disorder diagnoses, younger age of onset, and higher recurrence than single anxiety. Anxiety-MDD displayed greater clinical severity/complexity than MDD only. Anxiety-anxiety had more severe current anxiety symptoms, less severe current depressive symptoms, and reduced likelihood of self-reporting an anxiety/depressive disorder diagnosis than anxiety-MDD. Anxiety-first anxiety-MDD had a younger age of onset, more severe anxiety symptoms, and less likelihood of self-reporting a diagnosis than MDD-first. Minimal differences in familial risk were found.LimitationsSelf-report, retrospective measures may introduce recall bias. The familial risk analyses were likely underpowered.ConclusionsAnxiety-anxiety comorbidity displayed a similarly severe and complex profile of symptoms as anxiety-MDD but distinct features. For anxiety-MDD, first-onset anxiety had an earlier age of onset and greater severity than MDD-first. Anxiety disorders and comorbidity warrant further investigation and attention in research and practice.",

keywords = "Affective disorders, Anxiety disorders, Comorbidity, Depressive disorders, Polygenic risk score",

author = "Davies, {Molly R.} and Kiran Glen and Jessica Mundy and Kuile, {Abigail R. ter} and Adey, {Brett N.} and Ch{\'e}rie Armour and Elham Assary and Coleman, {Jonathan R.I.} and Goldsmith, {Kimberley A.} and Hirsch, {Colette R.} and Matthew Hotopf and Christopher H{\"u}bel and Jones, {Ian R.} and Gursharan Kalsi and Georgina Krebs and McIntosh, {Andrew M.} and Genevi{\`e}ve Morneau-Vaillancourt and Peel, {Alicia J.} and Purves, {Kirstin L.} and Lee, {Sang Hyuck} and Megan Skelton and Smith, {Daniel J.} and David Veale and Walters, {James T.R.} and Young, {Katherine S.} and Johan Zvrskovec and Gerome Breen and Eley, {Thalia C.}",

year = "2023",

month = feb,

day = "15",

doi = "10.1016/j.jad.2022.11.051",

language = "English",

volume = "323",

pages = "280--291",

journal = "Journal of Affective Disorders",

issn = "0165-0327",

publisher = "Elsevier B.V.",

}

Davies, MR, Glen, K, Mundy, J, Kuile, ART, Adey, BN, Armour, C, Assary, E, Coleman, JRI, Goldsmith, KA, Hirsch, CR, Hotopf, M, Hübel, C, Jones, IR, Kalsi, G, Krebs, G, McIntosh, AM, Morneau-Vaillancourt, G, Peel, AJ, Purves, KL, Lee, SH, Skelton, M, Smith, DJ, Veale, D, Walters, JTR, Young, KS, Zvrskovec, J, Breen, G & Eley, TC 2023, 'Factors associated with anxiety disorder comorbidity', Journal of Affective Disorders, vol. 323, pp. 280-291. https://doi.org/10.1016/j.jad.2022.11.051

TY - JOUR

T1 - Factors associated with anxiety disorder comorbidity

AU - Davies, Molly R.

AU - Glen, Kiran

AU - Mundy, Jessica

AU - Kuile, Abigail R. ter

AU - Adey, Brett N.

AU - Armour, Chérie

AU - Assary, Elham

AU - Coleman, Jonathan R.I.

AU - Goldsmith, Kimberley A.

AU - Hirsch, Colette R.

AU - Hotopf, Matthew

AU - Hübel, Christopher

AU - Jones, Ian R.

AU - Kalsi, Gursharan

AU - Krebs, Georgina

AU - McIntosh, Andrew M.

AU - Morneau-Vaillancourt, Geneviève

AU - Peel, Alicia J.

AU - Purves, Kirstin L.

AU - Lee, Sang Hyuck

AU - Skelton, Megan

AU - Smith, Daniel J.

AU - Veale, David

AU - Walters, James T.R.

AU - Young, Katherine S.

AU - Zvrskovec, Johan

AU - Breen, Gerome

AU - Eley, Thalia C.

PY - 2023/2/15

Y1 - 2023/2/15

N2 - BackgroundAnxiety and depressive disorders often co-occur and the order of their emergence may be associated with different clinical outcomes. However, minimal research has been conducted on anxiety-anxiety comorbidity. This study examined factors associated with anxiety comorbidity and anxiety-MDD temporal sequence.MethodsOnline, self-report data were collected from the UK-based GLAD and COPING NBR cohorts (N = 38,775). Logistic regression analyses compared differences in sociodemographic, trauma, and clinical factors between single anxiety, anxiety-anxiety comorbidity, anxiety-MDD (major depressive disorder) comorbidity, and MDD-only. Additionally, anxiety-first and MDD-first anxiety-MDD were compared. Differences in familial risk were assessed in those participants with self-reported family history or genotype data.ResultsAnxiety-anxiety and anxiety-MDD had higher rates of self-reported anxiety or depressive disorder diagnoses, younger age of onset, and higher recurrence than single anxiety. Anxiety-MDD displayed greater clinical severity/complexity than MDD only. Anxiety-anxiety had more severe current anxiety symptoms, less severe current depressive symptoms, and reduced likelihood of self-reporting an anxiety/depressive disorder diagnosis than anxiety-MDD. Anxiety-first anxiety-MDD had a younger age of onset, more severe anxiety symptoms, and less likelihood of self-reporting a diagnosis than MDD-first. Minimal differences in familial risk were found.LimitationsSelf-report, retrospective measures may introduce recall bias. The familial risk analyses were likely underpowered.ConclusionsAnxiety-anxiety comorbidity displayed a similarly severe and complex profile of symptoms as anxiety-MDD but distinct features. For anxiety-MDD, first-onset anxiety had an earlier age of onset and greater severity than MDD-first. Anxiety disorders and comorbidity warrant further investigation and attention in research and practice.

AB - BackgroundAnxiety and depressive disorders often co-occur and the order of their emergence may be associated with different clinical outcomes. However, minimal research has been conducted on anxiety-anxiety comorbidity. This study examined factors associated with anxiety comorbidity and anxiety-MDD temporal sequence.MethodsOnline, self-report data were collected from the UK-based GLAD and COPING NBR cohorts (N = 38,775). Logistic regression analyses compared differences in sociodemographic, trauma, and clinical factors between single anxiety, anxiety-anxiety comorbidity, anxiety-MDD (major depressive disorder) comorbidity, and MDD-only. Additionally, anxiety-first and MDD-first anxiety-MDD were compared. Differences in familial risk were assessed in those participants with self-reported family history or genotype data.ResultsAnxiety-anxiety and anxiety-MDD had higher rates of self-reported anxiety or depressive disorder diagnoses, younger age of onset, and higher recurrence than single anxiety. Anxiety-MDD displayed greater clinical severity/complexity than MDD only. Anxiety-anxiety had more severe current anxiety symptoms, less severe current depressive symptoms, and reduced likelihood of self-reporting an anxiety/depressive disorder diagnosis than anxiety-MDD. Anxiety-first anxiety-MDD had a younger age of onset, more severe anxiety symptoms, and less likelihood of self-reporting a diagnosis than MDD-first. Minimal differences in familial risk were found.LimitationsSelf-report, retrospective measures may introduce recall bias. The familial risk analyses were likely underpowered.ConclusionsAnxiety-anxiety comorbidity displayed a similarly severe and complex profile of symptoms as anxiety-MDD but distinct features. For anxiety-MDD, first-onset anxiety had an earlier age of onset and greater severity than MDD-first. Anxiety disorders and comorbidity warrant further investigation and attention in research and practice.

KW - Affective disorders

KW - Anxiety disorders

KW - Comorbidity

KW - Depressive disorders

KW - Polygenic risk score

U2 - 10.1016/j.jad.2022.11.051

DO - 10.1016/j.jad.2022.11.051

M3 - Article

C2 - 36442657

SN - 0165-0327

VL - 323

SP - 280

EP - 291

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Factors associated with anxiety disorder comorbidity

Abstract

Keywords

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