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Depression's Most Common Comorbidities

February 14, 2018

A new study on the epidemiology of major depressive disorder (MDD) finds that people with a history of the condition are more likely to also have a history of substance use disorders than anxiety or personality disorders.

The study, published online in JAMA Psychiatry, looked at the occurrence of depression and other psychiatric disorders over the lifetime of more than 36,000 adults, as well as occurrences within the last 12 months.

Among those with a lifetime history of MDD, 57.9% had a history of a substance use disorder, 37.3% had a previous anxiety disorder, and 31.9% had a history of a personality disorder.

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As far as specific disorders, a history of alcohol use disorder (40.8%) and nicotine use disorder (38.9%) were most common in the lifetime MDD cohort.

“With increasingly positive attitudes toward substance use and increasing rates of adult SUDs and associated problems, MDD comorbidity with SUDs remains a substantial public health and economic burden,” wrote Deborah S. Hasin, PhD, Department of Psychiatry, Columbia University Medical Center, New York City, and colleagues. “Evidence suggests that efforts to self-manage depression with cannabis are increasing despite lack of evidence that cannabinoids are effective for this purpose; prospectively, cannabis worsens the course of depressive disorders.”

Borderline personality disorder (26.6%) and generalized anxiety disorder (20.5%) occurred the next most frequently.

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People with a history of MDD were least likely to have had antisocial personality disorder (7.4%) or agoraphobia (5%).

The study’s other findings include:

  • The lifetime prevalence of MDD was 20.6%;

  • The anxious/distressed specifier characterized 74.6% of MDD cases;

  • The mixed-features specifier characterized 15.5% of MDD cases;

  • Almost 70% of people with lifetime MDD received some type of treatment.

The participants in the study were from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III. Researchers interviewed them in-person in 2016 and 2017.

—Terri Airov


Hasin DS, Sarvet AL, Meyers JL, et al. Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States. JAMA Psychiatry. 2018 February 14;[Epub ahead of print]. 

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