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

BACKGROUND: Most prior studies of panic-depression comorbidity have been limited methodologically by use of small clinical samples and incomplete analyses. AIMS: 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). METHOD: The NCS is a nationally representative survey of the prevalences and correlates of major DSM-III-R disorders in the US household population. RESULTS: 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. CONCLUSIONS: 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. (March 2000)