MCLEAN-HOSPITAL-DEPRESSION-RESEARCH-FACILITY - EARLY-ONSET PHOBIC DISORDERS AND ADULT-ONSET MAJOR DEPRESSION

Background This study explores the temporal relationship between anxie ty and major depressive disorders in a cohort of patients with current major depression. Method Current prevalence and lifetime history of s pecific anxiety disorders were assessed using the Structured Clinical Interview for DSM - III - R Diagnosis (SCID - P) in 85 patients with D SM - III - R major depression. Consensus DSM - III - R diagnoses were assigned by art least two psychiatrists or psychologists. Results Twen ty-nine per cent met criteria for at least one current anxiety disorde r and 34% had at least one anxiety disorder at some point in their liv es. The mean (s. d.) age of onset oi anxiety disorder in the depressed patients with comorbid social or simple phobia(15 (9) years) was sign ificantly younger than was that of their major depression (25 (9) year s). In contrast, the mean (s.d.) age of onset of anxiety in patients w ith comorbid panic or OCD (20 (8) years) was similar to that seen for their major depression (21 (9) years). In patients with major depressi on with comorbid anxiety disorders, both the social phobia (10 of 13) and simple phobia (4 of 4) were more commonly reported to start at lea st two years prior to their major depression in contrast to depressive s with comorbid panic (3 of 10 subjects) - Fisher's exact test, P = 0. 01. Conclusions Early-onset social and simple phobias appear to be ris k factors for later onset of major depression.