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Patterns of co-morbidity with anxiety disorders in Chinese women with recurrent major depression

  • Y. Li (a1), S. Shi (a2) (a3), F. Yang (a3), J. Gao (a4), Youhui Li (a5), M. Tao (a6), G. Wang (a7), K. Zhang (a8), C. Gao (a9), L. Liu (a10), Kan Li (a11), Keqing Li (a12), Y. Liu (a13), Xumei Wang (a14), J. Zhang (a15), L. Lv (a16), Xueyi Wang (a17), Q. Chen (a18), J. Hu (a19), L. Sun (a20), J. Shi (a21), Y. Chen (a22), D. Xie (a1), J. Flint (a1), K. S. Kendler (a23) and Z. Zhang (a24)
  • DOI:
  • Published online: 30 November 2011

Studies conducted in Europe and the USA have shown that co-morbidity between major depressive disorder (MDD) and anxiety disorders is associated with various MDD-related features, including clinical symptoms, degree of familial aggregation and socio-economic status. However, few studies have investigated whether these patterns of association vary across different co-morbid anxiety disorders. Here, using a large cohort of Chinese women with recurrent MDD, we examine the prevalence and associated clinical features of co-morbid anxiety disorders.


A total of 1970 female Chinese MDD patients with or without seven co-morbid anxiety disorders [including generalized anxiety disorder (GAD), panic disorder, and five phobia subtypes] were ascertained in the CONVERGE study. Generalized linear models were used to model association between co-morbid anxiety disorders and various MDD features.


The lifetime prevalence rate for any type of co-morbid anxiety disorder is 60.2%. Panic and social phobia significantly predict an increased family history of MDD. GAD and animal phobia predict an earlier onset of MDD and a higher number of MDD episodes, respectively. Panic and GAD predict a higher number of DSM-IV diagnostic criteria. GAD and blood-injury phobia are both significantly associated with suicidal attempt with opposite effects. All seven co-morbid anxiety disorders predict higher neuroticism.


Patterns of co-morbidity between MDD and anxiety are consistent with findings from the US and European studies; the seven co-morbid anxiety disorders are heterogeneous when tested for association with various MDD features.

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Corresponding author
*Address for correspondence: K. S. Kendler, M.D., Virginia Institute for Psychiatric and Behavioral Genetics of Virginia Commonwealth University, Box 980126, Richmond, VA 232980126, USA. (Email: [K.S.K.]
(Email: [Z. Zhang]
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