ADad 7: Relationship between depression and Anxiety Disorders among adolescents in a rural community population in India.
OBJECTIVE
Anxiety Disorders (AD) often co-exist with the heterotypic co-morbidity of Major Depressive Disorder (MDD) and Dysthymia (DysD). This study documents the prevalence of concurrent Depressive Disorder and its subtypes among AD, relationship between specific AD and Depressive Disorders, influence of severity of Depressive Disorders (DD) on AD and vice-versa, as well as the effect of age and gender on this co-morbidity.


METHODS
In a prospective community survey of 500 adolescents, independent raters administered the Screen for Child Anxiety Related Emotional Disorders, Beck Depression Inventory and Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version to collect the required data. Descriptive statistics, Independent t tests and Chi-square tests were done to evaluate the prevalence of concurrent Depressive Disorders among AD, relationship between specific AD and Depressive Disorders, severity of DD, and effect of age and gender on this co-morbidity.


RESULTS
Depressive Disorders were concurrently present in 23.7% of adolescents with AD, while 13.9% had concurrently only MDD, 8.3% had only DysD and 1.5% had both. More adolescents with AD had multiple mood disorders than otherwise. Twenty percent of adolescents with Panic Disorder, 12.1% with Generalised anxiety Disorder, 5.3% with Separation Anxiety Disorder and 12% with Social Anxiety Disorder had Depressive Disorders. Dysthymic disorder was statistically significantly more among those with PD (P = 0.009). Depressive Disorders were more severe among those with AD (P = 0.001) and the AD was more severe in those with DD (P = 0.01). As the severity of AD increased the severity of the DD also increased (P = 0.001). While DD were more prevalent among the late adolescence (P = 0.001), gender did not have any influence.


CONCLUSIONS
The two-way overlap between AD and DD is prevalent. Adolescents with Anxiety Disorders should be screened for Depressive Disorders, and when present should be treated.
Child and Adolescent Psychiatry Unit, Christian Medical College, Vellore, 632 002, Tamil Nadu, South India, russell@cmcvellore.ac.in.
Paul Swamidhas Sudhakar
PS
Russell
M K C
MK
Nair
Satya Raj
SR
Shankar
Sherab
S
Tsheringla
Praveen Kumar
PK
Jakati
Neethu
N
Chembagam
Suma
S
Nazeema
D000293:Adolescent; D001008:Anxiety Disorders / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D019263:Dysthymic Disorder / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D055815:Young Adult