Comorbidity of depression and panic disorder.
The high comorbidity of panic disorder and depression might be anticipated on epidemiologic grounds alone. Both are common disorders with a characteristically chronic course, increasing the probability that a given patient with one disorder will develop the other. Symptoms of anxiety are highly prevalent among depressed patients; however, not all such symptoms represent an actual comorbid anxiety disorder. Conversely, about 50% of patients with panic disorder ultimately experience an episode of major depression. The comorbidity of panic disorder and depression has significant and potentially ominous prognostic implications; the high rate of suicide attempts observed in panic disorder are further exacerbated by the presence of a comorbid depression. Panic disorder and depression share well-defined disturbances in hypothalamic-pituitary-adrenal axis function, serotonergic neurotransmission, and growth hormone response to pharmacologic challenge. In addition, most of the available medications used to treat depression are also first-line therapy for panic disorder. Although initial studies suggested that patients with comorbid panic disorder and depression have a poorer treatment outcome, recent data show similar outcomes for patients with both disorders and those with panic disorder uncomplicated by depression.
New York State Psychiatric Institute, N.Y. 10032, USA.
J M
JM
Gorman
J D
JD
Coplan
D000328:Adult; D003000:Clonidine / Q000494:pharmacology / Q000627:therapeutic use; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D019382:Human Growth Hormone / Q000097:blood / Q000502:physiology; D006801:Humans; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012701:Serotonin / Q000502:physiology; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D009626:Terminology as Topic; D016896:Treatment Outcome
D019382:Human Growth Hormone; D012701:Serotonin; D003000:Clonidine