title: The role of personality in comorbidity among anxiety and depressive disorders in primary care and specialty care: a cross-sectional analysis.
abstract: OBJECTIVE
  Almost no cross-sectional studies directly compared the rate and pattern of comorbidity of affective disorders in relation to personality traits of patients seen in primary care versus specialty mental health care.
  
  
  METHODS
  Using data from the Netherlands Study of Depression and Anxiety, we compared 1086 primary care patients with 790 consecutive specialized mental health care patients. All participants had at least one lifetime Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition-based diagnosis of depression or anxiety. Personality was assessed with the NEO Five-Factor Inventory.
  
  
  RESULTS
  In both settings it was common to have at least one lifetime comorbid affective disorder. Compared to primary care patients, specialty care patients showed elevated scores for Neuroticism and lower scores for Extraversion and Conscientiousness. The odds of having another disorder given any one disorder was no longer significant after accounting for personality dimensions. Only Neuroticism proved to be positively associated with comorbidity per se.
  
  
  CONCLUSIONS
  Prevalence of and comorbidity among anxiety and depressive disorders in primary care were very similar to those in specialty care. Neuroticism - but no other personality traits - may help to understand the comorbidity among anxiety and depressive disorders irrespective of recruitment setting.
authors.affiliation: Institute of Psychology, Department of Psychology, Leiden University, Leiden, The Netherlands. spinhoven@fsw.leidenuniv.nl
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.forename: Mark
authors.initials: M
authors.lastname: de Rooij
authors.forename: Willem
authors.initials: W
authors.lastname: Heiser
authors.forename: Jan H
authors.initials: JH
authors.lastname: Smit
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000328:Adult; D001008:Anxiety Disorders; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008511:Medicine; D008875:Middle Aged; D009426:Netherlands; D010551:Personality; D011320:Primary Health Care