Comorbidity of depression and panic disorder

J Clin Psychiatry. 1996;57 Suppl 10:34-41; discussion 42-3.

Abstract

The high comorbidity of panic disorder and depression might be anticipated on epidemiologic grounds alone. Both are common disorders with a characteristically chronic course, increasing the probability that a given patient with one disorder will develop the other. Symptoms of anxiety are highly prevalent among depressed patients; however, not all such symptoms represent an actual comorbid anxiety disorder. Conversely, about 50% of patients with panic disorder ultimately experience an episode of major depression. The comorbidity of panic disorder and depression has significant and potentially ominous prognostic implications; the high rate of suicide attempts observed in panic disorder are further exacerbated by the presence of a comorbid depression. Panic disorder and depression share well-defined disturbances in hypothalamic-pituitary-adrenal axis function, serotonergic neurotransmission, and growth hormone response to pharmacologic challenge. In addition, most of the available medications used to treat depression are also first-line therapy for panic disorder. Although initial studies suggested that patients with comorbid panic disorder and depression have a poorer treatment outcome, recent data show similar outcomes for patients with both disorders and those with panic disorder uncomplicated by depression.

Publication types

  • Review

MeSH terms

  • Adult
  • Clonidine / pharmacology
  • Clonidine / therapeutic use
  • Comorbidity
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / physiopathology
  • Human Growth Hormone / blood
  • Human Growth Hormone / physiology
  • Humans
  • Panic Disorder / diagnosis
  • Panic Disorder / epidemiology*
  • Panic Disorder / physiopathology
  • Prognosis
  • Psychiatric Status Rating Scales
  • Serotonin / physiology
  • Suicide, Attempted / statistics & numerical data
  • Terminology as Topic
  • Treatment Outcome

Substances

  • Human Growth Hormone
  • Serotonin
  • Clonidine