title: Lifetime panic-depression comorbidity in the National Comorbidity Survey. Association with symptoms, impairment, course and help-seeking.
abstract: BACKGROUND
  Most prior studies of panic-depression comorbidity have been limited methodologically by use of small clinical samples and incomplete analyses.
  
  
  OBJECTIVE
  General population data were used to study the association of lifetime and recent (12 months) panic-depression comorbidity with symptom severity, impairment, course and help-seeking in the National Comorbidity Survey (NCS).
  
  
  METHODS
  The NCS is a nationally representative survey of the prevalences and correlates of major DSM-III-R disorders in the US household population.
  
  
  RESULTS
  Strong lifetime and current comorbidity were found between panic and depression. Comorbidity was associated with greater symptom severity, persistence, role impairment, suicidality and help-seeking, with many findings persisting after controlling for additional comorbid diagnoses. Findings did not differ according to which disorder was chronologically primary.
  
  
  CONCLUSIONS
  Both lifetime and current panic-depression comorbidity are markers for more severe, persistent and disabling illness. Neither additional comorbid diagnoses nor the primary-secondary distinction were important moderators of these associations.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA.
authors.forename: P P
authors.initials: PP
authors.lastname: Roy-Byrne
authors.forename: P
authors.initials: P
authors.lastname: Stang
authors.forename: H U
authors.initials: HU
authors.lastname: Wittchen
authors.forename: B
authors.initials: B
authors.lastname: Ustun
authors.forename: E E
authors.initials: EE
authors.lastname: Walters
authors.forename: R C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000453:epidemiology*; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology