The influence of anxiety as a risk to early onset major depression - PubMed (original) (raw)
The influence of anxiety as a risk to early onset major depression
G Parker et al. J Affect Disord. 1999 Jan-Mar.
Abstract
Objective: we seek to identify and quantify any risk provided by several expressions of "anxiety" to major depression overall, and to separate melancholic and non-melancholic sub-types.
Method: a sample of 269 patients with a current major depressive episode was assessed for rates of separate formalised anxiety disorders, both for lifetime and prior to the initial depressive episode. We also sought for evidence of familial anxiety and, early childhood expression of anxiety forerunners, measured both state and trait anxiety levels as well as anxiety at a "personality" level, and assessed use of anxiolytic medications. Depressive sub-typing was undertaken using DSM-IV criteria, while "early onset" (EO) depression was defined as an initial onset at 25 years or less, and subsequently re-examined with a cut-off age of 20 years or less.
Results: overall. 42% of our sample were assigned as having EO depression, with there being a higher representation of non-melancholic than melancholic EO subjects (i.e., 51% vs. 29%), arguing for sub-type status being respected in the analyses. For both melancholic and non-melancholic subjects two trait anxiety items ("tense"; "keyed up/on edge") were over-represented, suggesting that such a tense anxiety style may provide an antecedent risk to depression (of either sub-type) or be a consequence of depression. Specificity was most evident in the non-melancholic sub-sample, where EO depression was associated with a family history of anxiety, early childhood expressions of anxiety and with two lifetime anxiety disorders (social phobia and obsessive-compulsive disorder). Broadly similar results were returned when "EO" definition was reduced to 20 years or less.
Conclusions: our study is consistent with previous research in identifying anxiety in the form of social inhibition or social avoidance as being particularly likely to precede and perhaps be a conduit to early onset non-melancholic major depression. This conclusion both sharpens risk factor research and indicates an important fulcrum that could be used to assist primary prevention of the depressive disorders.
Similar articles
- Disordered personality style: higher rates in non-melancholic compared to melancholic depression.
Parker G, Roussos J, Austin MP, Hadzi-Pavlovic D, Wilhelm K, Mitchell P. Parker G, et al. J Affect Disord. 1998 Jan;47(1-3):131-40. doi: 10.1016/s0165-0327(97)00133-x. J Affect Disord. 1998. PMID: 9476753 - Sub-grouping non-melancholic depression from manifest clinical features.
Parker G, Roy K, Wilhelm K, Mitchell P, Austin MP, Hadzi-Pavlovic D, Little C. Parker G, et al. J Affect Disord. 1999 Apr;53(1):1-13. doi: 10.1016/s0165-0327(98)00100-1. J Affect Disord. 1999. PMID: 10363661 - Distinguishing early and late onset non-melancholic unipolar depression.
Parker G, Roy K, Hadzi-Pavlovic D, Mitchell P, Wilhelm K. Parker G, et al. J Affect Disord. 2003 Apr;74(2):131-8. doi: 10.1016/s0165-0327(02)00002-2. J Affect Disord. 2003. PMID: 12706514 - Atypical depression: a reappraisal.
Parker G, Roy K, Mitchell P, Wilhelm K, Malhi G, Hadzi-Pavlovic D. Parker G, et al. Am J Psychiatry. 2002 Sep;159(9):1470-9. doi: 10.1176/appi.ajp.159.9.1470. Am J Psychiatry. 2002. PMID: 12202264 Review. - Identifying and differentiating melancholic depression in a non-clinical sample.
Parker G, Tavella G, Hadzi-Pavlovic D. Parker G, et al. J Affect Disord. 2019 Jan 15;243:194-200. doi: 10.1016/j.jad.2018.09.024. Epub 2018 Sep 12. J Affect Disord. 2019. PMID: 30245251 Review.
Cited by
- The relationship between anxiety and depression under the pandemic: The role of life meaning.
Shek DTL, Chai W, Tan L. Shek DTL, et al. Front Psychol. 2022 Nov 28;13:1059330. doi: 10.3389/fpsyg.2022.1059330. eCollection 2022. Front Psychol. 2022. PMID: 36518968 Free PMC article. - Types of Anxiety and Depression: Theoretical Assumptions and Development of the Anxiety and Depression Questionnaire.
Fajkowska M, Domaradzka E, Wytykowska A. Fajkowska M, et al. Front Psychol. 2018 Jan 23;8:2376. doi: 10.3389/fpsyg.2017.02376. eCollection 2017. Front Psychol. 2018. PMID: 29410638 Free PMC article. - On the Role of Glutamate in Presynaptic Development: Possible Contributions of Presynaptic NMDA Receptors.
Fedder KN, Sabo SL. Fedder KN, et al. Biomolecules. 2015 Dec 14;5(4):3448-66. doi: 10.3390/biom5043448. Biomolecules. 2015. PMID: 26694480 Free PMC article. Review. - Postnatal day 2 to 11 constitutes a 5-HT-sensitive period impacting adult mPFC function.
Rebello TJ, Yu Q, Goodfellow NM, Caffrey Cagliostro MK, Teissier A, Morelli E, Demireva EY, Chemiakine A, Rosoklija GB, Dwork AJ, Lambe EK, Gingrich JA, Ansorge MS. Rebello TJ, et al. J Neurosci. 2014 Sep 10;34(37):12379-93. doi: 10.1523/JNEUROSCI.1020-13.2014. J Neurosci. 2014. PMID: 25209278 Free PMC article. - Changes in Regional Homogeneity of Medication-Free Major Depressive Disorder Patients With Different Onset Ages.
Zhang Z, Chen Y, Wei W, Yang X, Meng Y, Yu H, Guo W, Wang Q, Deng W, Li T, Ma X. Zhang Z, et al. Front Psychiatry. 2021 Oct 1;12:713614. doi: 10.3389/fpsyt.2021.713614. eCollection 2021. Front Psychiatry. 2021. PMID: 34658953 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical