Major Depressive Disorder and Axis I Diagnostic Comorbidity
J Clin Psychiatry 2002;63(3):187-193
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Background: Recognition of comorbid conditions in patients presenting
for the treatment of depression is clinically important because the presence of
other disorders can influence treatment planning. In the present study, we examined
the frequency of diagnostic comorbidity in psychiatric outpatients presenting
for treatment of nonbipolar major depressive disorder (MDD) and patients' desire
for treatment for the comorbid disorders.
Method: Four hundred seventy-nine
psychiatric outpatients with DSM-IV nonbipolar MDD were evaluated with a modified version of
the Structured Clinical Interview for DSM-IV.
Results: Excluding nicotine dependence,
at the time of the evaluation 64.1% (N=307) of the patients met criteria for at least 1 of the 23
specific Axis I disorders, and more than one third (36.7%, N=176) had 2 or more disorders.
Anxiety disorders, as a group, were the most
frequent current comorbid disorders (56.8%), and
social phobia was the most frequent individual
disorder. Including subthreshold conditions, the
percentage of patients with at least 1 disorder increased
to 73.5%. When the scope of assessment was expanded to include nicotine dependence,
nicotine dependence was the most frequent lifetime
individual disorder (38.2%) and the second most
frequent current disorder (27.3%). There was considerable variability among the
disorders regarding desire for treatment of the
Conclusion: The majority of nonbipolar
depressed patients have a current comorbid
disorder, especially an anxiety disorder, although the
actual rate of comorbidity depends on the breadth of