Abstract
The comorbidity of major depressive disorder (MDD) and generalized anxiety disorder (GAD) is common and often predicts poorer outcomes than either disorder alone. This study aimed to examine the prevalence of comorbid GAD and its association with quality of life (QOL) among MDD patients. A total of 1225 psychiatric outpatients were screened using the Hospital Anxiety and Depression Scale (HADS). Those who scored ≥8 on the HADS were interviewed using DSM-IV criteria by two senior psychiatrists. Patients diagnosed with MDD were further assessed using the 9-item Patient Health Questionnaire, Social Support Rating Scale, Pittsburgh Sleep Quality Index, and World Health Organization QOL Scale, brief version (WHOQOL-BREF). Ultimately, 667 patients were diagnosed with MDD, of 71.7% of whom had GAD. Compared to those with MDD alone, comorbid patients had lower scores on the physical (38.64 ± 10.35 vs.36.54 ± 12.32, P = 0.026) and psychological (35.54 ± 12.98 vs. 30.61 ± 14.66, P < 0.001) domains of the WHOQOL-BREF. The association between comorbid GAD and poor QOL on the two domains remained statistically significant in the multiple linear regression (unstandardized coefficients: −1.97 and −4.65, P < 0.001). In conclusion, the prevalence of comorbid GAD in MDD patients is high, and co-occurring GAD may exacerbate impaired physical and psychological QOL in Chinese MDD patients.
Highlights
Values and clinical characteristics of comorbid depressive disorder and anxiety disorder[15,16]
The present study examined the clinical epidemiology of generalized anxiety disorder (GAD) and its potential effect on the QOL of patients with Major depressive disorder (MDD)
We found that (1) the prevalence of comorbidity of MDD and GAD was high in Chinese MDD patients, (2) MDD patients with GAD had more depressive symptoms, reduced sleep quality and poorer physical and psychological QOL compared to patients with MDD only, and (3) co-occurring MDD and GAD was still significantly associated with lower physical and psychological QOL, after adjusting for potential confounders
Summary
Values and clinical characteristics of comorbid depressive disorder and anxiety disorder[15,16]. To the best of our knowledge, no research has examined the impact of comorbid GAD on the QOL of Chinese MDD patients in clinical settings. Research has indicated that MDD patients’ QOL is poorer than that of patients with physical disease[23]. It has been well-established that co-existing depression and anxiety poses the greatest threat to QOL10,24. Current evidence relating to the association between MDD and comorbid anxiety disorder with poor QOL has almost exclusively been derived from research conducted in developed countries. The present study investigated the prevalence and socio-demographic characteristics of comorbid GAD in Chinese outpatients with MDD, and examined the association of such comorbidity with their QOL
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