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Major Depression in Patients With Agoraphobia and Panic Disorder

Major Depression in Patients With Agoraphobia and Panic Disorder Abstract • A review of the life-time occurrence of major depression, the temporal relationship of major depression to episodes of panic and agoraphobic disorders, and the severity of anxiety and depressive symptoms were determined In 60 patients with agoraphobia or panic disorder. Forty-one (68%) of the patients had a past or current episode of major depression, and 35 (85%) of these patients had endogenous-type major depression. Twenty patients (33%) had an episode of primary major depression, and an average of three years separated the end of primary major depression and the first panic attack. Secondary major depression occurred in 28 patients. Patients with a history of major depression had a more severe anxiety disorder. These data support the view that In a subgroup of patients, episodes of depression and panic anxiety disorder may be manifestations of a common underlying pathogenic process. References 1. Roth M, Gurney C, Garside RF, et al: Studies in the classification of affective disorders: The relationship between anxiety states and depressive illness . Br J Psychiatry 1972;121:147-161.Crossref 2. Gurney C, Roth M, Garside RF, Kerr TA: Studies in the classification of affective disorders: The relationship between anxiety states and depressive illness . Br J Psychiatry 1972;121:162-166.Crossref 3. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980. 4. Klein DF: Anxiety reconceptualized , in Klein DF, Raskin J (eds): Anxiety: New Research and Changing Concepts . New York, Raven Press, 1981, pp 235-263. 5. Sheehan DV: Panic attacks and phobias . N Engl J Med 1982;3:156-158.Crossref 6. Munjack DJ, Moss HB: Affective disorder and alcoholism in families of agoraphobics . Arch Gen Psychiatry 1981;38:869-871.Crossref 7. Bowen RC, Kohout J: The relationship between agoraphobia and primary affective disorders . Can J Psychiatry 1979;24:317-322. 8. Leckman JF, Weissman MM, Merikangas KR, Pauls DL, Prusoff BA: Panic disorder increases risk of major depression, alcoholism, panic, and phobic disorders in affectively ill families . Arch Gen Psychiatry 1983;40:1055-1060.Crossref 9. Cloninger CR, Martin RL, Clayton P, Guze SB: A blind follow-up and family study of anxiety neurosis: Preliminary analysis of the St Louis 500 , in Klein DF, Rabkin J (eds): Anxiety: New Research and Changing Concepts . New York, Raven Press, 1981, pp 137-148. 10. Dealy RS, Ishiki DM, Avery DH, Wilson LG, Dunner DL: Secondary depression in anxiety disorders . Compr Psychiatry 1981;22:612-618.Crossref 11. Zitrin GM, Klein DF, Woerner MG, Ross DC: Treatment of phobias: Comparison of imipramine and placebo . Arch Gen Psychiatry 1983;40:125-138.Crossref 12. Sheehan DV, Ballenger J, Jacobsen G: Treatment of endogenous anxiety with phobic, hysterical and hypochondriacal symptoms . Arch Gen Psychiatry 1980;37:51-59.Crossref 13. Mountjoy CQ, Roth M, Garside RF, Leitch IM: A clinical trial of phenelzine in anxiety depressive and phobic neuroses . Br J Psychiatry 1977;131:486-492.Crossref 14. Raskin M, Peeke HVS, Dickman W, Pinsker H: Panic and generalized anxiety disorders: Developmental antecedents and precipitants . Arch Gen Psychiatry 1982;39:687-689.Crossref 15. Buglass D, Clarke J, Henderson AS: A study of agoraphobic housewives . Psychol Med 1977;7:73-86.Crossref 16. Pariser SF, Jones BA, Pinta ER, Young EA, Fontana ME: Panic attacks: Diagnostic evaluation of 17 patients . Am J Psychiatry 1979;136:105-106. 17. Gardos G: Is agoraphobia a psychosomatic form of depression , in Klein DF, Raskin J (eds): Anxiety: New Research and Changing Concepts . New York, Raven Press, 1981, pp 235-263. 18. Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders , ed 3. New York, New York State Psychiatric Institute, 1977. 19. Spitzer RL, Endicott J: Schedule for Affective Disorders and Schizophrenia (SADS) . New York, New York State Psychiatric Institute, 1978. 20. Leckman JF, Sholomskas D, Thompson WD, Belanger A, Weissman MM: Best estimate of lifetime psychiatric diagnosis: A methodological study . Arch Gen Psychiatry 1982;39:879-883.Crossref 21. Fayer A, Endicott J: The Schedule for Affective Disorders and Schizophrenia Lifetime Version-Modified for Study of Anxiety Disorders . New York, New York State Psychiatric Institute, 1984. 22. Hamilton M: Diagnosis and ratings of anxiety . Br J Psychiatry 1969;3:76-79. 23. Hamilton M: A rating scale for depression . J Neurol Neurosurg Psychiatry 1960;23:56-62.Crossref 24. Wolpe J, Lange PJ: A fear survey schedule for use in behavior therapy . Behav Res Ther 1964;2:27-30.Crossref 25. Leckman JF, Merikangas KP, Pauls DL, Prusoff BA, Weissman MM: Anxiety disorders and depression: Contradictions between family study data and DSM-III convention . Am J Psychiatry 1983;140:880-882. 26. Snaith RP: A clinical investigation of phobia . Br J Psychiatry 1968;114:673-697.Crossref 27. Katz MM, Hirschfield RMA: Phenomenology and classification of depression in Lipton MA, DiMascio A, Killman KF (eds): Psychopharmacology: A Generation of Progress . New York, Raven Press, 1978, pp 1185-1195. 28. Nurnberger JI, Gershon ES: Genetics , in Paykel ES (ed): Handbook of Affective Disorders . New York, Guilford Press, 1982, pp 126-145. 29. Koslow SH, Maas JW, Bowden CL, Davis JM, Hanin I, Javald J: CSF and urinary biogenic amines and metabolites in depression and mania: A controlled, univariate analysis . Arch Gen Psychiatry 1983;40:999-1010.Crossref 30. Pollit J, Young J: Anxiety state or masked depression? A study based on the action of monoamine oxidase inhibitors . Br J Psychiatry 1971;119:143-149.Crossref 31. Fawcett J, Kravitz HM: Anxiety syndromes and their relationship to depressive illness . J Clin Psychiatry 1983;44:8-11. 32. Quitkin F, Rifkin A, Klein DF: Monoamine oxidase inhibitors: A review of antidepressant effectiveness . Arch Gen Psychiatry 1979;36:749-760.Crossref 33. Plaznik A, Danysz W, Kostowski W, Bidzinski A, Hauptman M: Interaction between noradrenergic and serotonergic brain systems as evidence by behavioral and biochemical effects of microinjections of adrenergic agonists and antagonists into the median raphe nucleus . Pharmacol Biochem Behav 1983;19:27-32.Crossref 34. Chouinard G, Annable L, Fontaine R, Solyom L: Alprazolam in the treatment of generalized anxiety and panic disorders: A double-blind, placebo-controlled study . Psychopharmacology 1982;77:229-233.Crossref 35. Feighner JB, Aden GC, Fabre LF, Rickels K, Smith WT: Comparison of alprazolam, imipramine and placebo in the treatment of depression . JAMA 1983;249:3057-3064.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Major Depression in Patients With Agoraphobia and Panic Disorder

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1984.01790230015002
Publisher site
See Article on Publisher Site

Abstract

Abstract • A review of the life-time occurrence of major depression, the temporal relationship of major depression to episodes of panic and agoraphobic disorders, and the severity of anxiety and depressive symptoms were determined In 60 patients with agoraphobia or panic disorder. Forty-one (68%) of the patients had a past or current episode of major depression, and 35 (85%) of these patients had endogenous-type major depression. Twenty patients (33%) had an episode of primary major depression, and an average of three years separated the end of primary major depression and the first panic attack. Secondary major depression occurred in 28 patients. Patients with a history of major depression had a more severe anxiety disorder. These data support the view that In a subgroup of patients, episodes of depression and panic anxiety disorder may be manifestations of a common underlying pathogenic process. References 1. Roth M, Gurney C, Garside RF, et al: Studies in the classification of affective disorders: The relationship between anxiety states and depressive illness . Br J Psychiatry 1972;121:147-161.Crossref 2. Gurney C, Roth M, Garside RF, Kerr TA: Studies in the classification of affective disorders: The relationship between anxiety states and depressive illness . Br J Psychiatry 1972;121:162-166.Crossref 3. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980. 4. Klein DF: Anxiety reconceptualized , in Klein DF, Raskin J (eds): Anxiety: New Research and Changing Concepts . New York, Raven Press, 1981, pp 235-263. 5. Sheehan DV: Panic attacks and phobias . N Engl J Med 1982;3:156-158.Crossref 6. Munjack DJ, Moss HB: Affective disorder and alcoholism in families of agoraphobics . Arch Gen Psychiatry 1981;38:869-871.Crossref 7. Bowen RC, Kohout J: The relationship between agoraphobia and primary affective disorders . Can J Psychiatry 1979;24:317-322. 8. Leckman JF, Weissman MM, Merikangas KR, Pauls DL, Prusoff BA: Panic disorder increases risk of major depression, alcoholism, panic, and phobic disorders in affectively ill families . Arch Gen Psychiatry 1983;40:1055-1060.Crossref 9. Cloninger CR, Martin RL, Clayton P, Guze SB: A blind follow-up and family study of anxiety neurosis: Preliminary analysis of the St Louis 500 , in Klein DF, Rabkin J (eds): Anxiety: New Research and Changing Concepts . New York, Raven Press, 1981, pp 137-148. 10. Dealy RS, Ishiki DM, Avery DH, Wilson LG, Dunner DL: Secondary depression in anxiety disorders . Compr Psychiatry 1981;22:612-618.Crossref 11. Zitrin GM, Klein DF, Woerner MG, Ross DC: Treatment of phobias: Comparison of imipramine and placebo . Arch Gen Psychiatry 1983;40:125-138.Crossref 12. Sheehan DV, Ballenger J, Jacobsen G: Treatment of endogenous anxiety with phobic, hysterical and hypochondriacal symptoms . Arch Gen Psychiatry 1980;37:51-59.Crossref 13. Mountjoy CQ, Roth M, Garside RF, Leitch IM: A clinical trial of phenelzine in anxiety depressive and phobic neuroses . Br J Psychiatry 1977;131:486-492.Crossref 14. Raskin M, Peeke HVS, Dickman W, Pinsker H: Panic and generalized anxiety disorders: Developmental antecedents and precipitants . Arch Gen Psychiatry 1982;39:687-689.Crossref 15. Buglass D, Clarke J, Henderson AS: A study of agoraphobic housewives . Psychol Med 1977;7:73-86.Crossref 16. Pariser SF, Jones BA, Pinta ER, Young EA, Fontana ME: Panic attacks: Diagnostic evaluation of 17 patients . Am J Psychiatry 1979;136:105-106. 17. Gardos G: Is agoraphobia a psychosomatic form of depression , in Klein DF, Raskin J (eds): Anxiety: New Research and Changing Concepts . New York, Raven Press, 1981, pp 235-263. 18. Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders , ed 3. New York, New York State Psychiatric Institute, 1977. 19. Spitzer RL, Endicott J: Schedule for Affective Disorders and Schizophrenia (SADS) . New York, New York State Psychiatric Institute, 1978. 20. Leckman JF, Sholomskas D, Thompson WD, Belanger A, Weissman MM: Best estimate of lifetime psychiatric diagnosis: A methodological study . Arch Gen Psychiatry 1982;39:879-883.Crossref 21. Fayer A, Endicott J: The Schedule for Affective Disorders and Schizophrenia Lifetime Version-Modified for Study of Anxiety Disorders . New York, New York State Psychiatric Institute, 1984. 22. Hamilton M: Diagnosis and ratings of anxiety . Br J Psychiatry 1969;3:76-79. 23. Hamilton M: A rating scale for depression . J Neurol Neurosurg Psychiatry 1960;23:56-62.Crossref 24. Wolpe J, Lange PJ: A fear survey schedule for use in behavior therapy . Behav Res Ther 1964;2:27-30.Crossref 25. Leckman JF, Merikangas KP, Pauls DL, Prusoff BA, Weissman MM: Anxiety disorders and depression: Contradictions between family study data and DSM-III convention . Am J Psychiatry 1983;140:880-882. 26. Snaith RP: A clinical investigation of phobia . Br J Psychiatry 1968;114:673-697.Crossref 27. Katz MM, Hirschfield RMA: Phenomenology and classification of depression in Lipton MA, DiMascio A, Killman KF (eds): Psychopharmacology: A Generation of Progress . New York, Raven Press, 1978, pp 1185-1195. 28. Nurnberger JI, Gershon ES: Genetics , in Paykel ES (ed): Handbook of Affective Disorders . New York, Guilford Press, 1982, pp 126-145. 29. Koslow SH, Maas JW, Bowden CL, Davis JM, Hanin I, Javald J: CSF and urinary biogenic amines and metabolites in depression and mania: A controlled, univariate analysis . Arch Gen Psychiatry 1983;40:999-1010.Crossref 30. Pollit J, Young J: Anxiety state or masked depression? A study based on the action of monoamine oxidase inhibitors . Br J Psychiatry 1971;119:143-149.Crossref 31. Fawcett J, Kravitz HM: Anxiety syndromes and their relationship to depressive illness . J Clin Psychiatry 1983;44:8-11. 32. Quitkin F, Rifkin A, Klein DF: Monoamine oxidase inhibitors: A review of antidepressant effectiveness . Arch Gen Psychiatry 1979;36:749-760.Crossref 33. Plaznik A, Danysz W, Kostowski W, Bidzinski A, Hauptman M: Interaction between noradrenergic and serotonergic brain systems as evidence by behavioral and biochemical effects of microinjections of adrenergic agonists and antagonists into the median raphe nucleus . Pharmacol Biochem Behav 1983;19:27-32.Crossref 34. Chouinard G, Annable L, Fontaine R, Solyom L: Alprazolam in the treatment of generalized anxiety and panic disorders: A double-blind, placebo-controlled study . Psychopharmacology 1982;77:229-233.Crossref 35. Feighner JB, Aden GC, Fabre LF, Rickels K, Smith WT: Comparison of alprazolam, imipramine and placebo in the treatment of depression . JAMA 1983;249:3057-3064.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Dec 1, 1984

References