Lifetime panic-depression comorbidity in the National Comorbidity Survey: Association with symptoms, impairment, course and help-seeking

Most prior studies of panic-depression comorbidity have been limited methodologically by use of small clinical samples and incomplete analyses. General population data were used to study the association of lifetime and recent (12 months) panic-depression comorbidity with symptom severity, impairment, course and help-seeking in the National Comorbidity Survey (NCS). The NCS is a nationally representative survey of the prevalences and correlates of major DSM-III-R disorders in the US household population. Strong lifetime and current comorbidity were found between panic and depression. Comorbidity was associated with greater symptom severity, persistence, role impairment, suicidality and help-seeking, with many findings persisting after controlling for additional comorbid diagnoses. Findings did not differ according to which disorder was chronologically primary. Both lifetime and current panic-depression comorbidity are markers for more severe, persistent and disabling illness. Neither additional comorbid diagnoses nor the primary-secondary distinction were important moderators of these associations.