Prevalence and disability of comorbid social phobia and obsessive-compulsive disorder in patients with panic disorder and generalized anxiety disorder

Int J Psychiatry Clin Pract. 2014 Oct;18(4):248-54. doi: 10.3109/13651501.2014.959972. Epub 2014 Oct 7.

Abstract

Objective: Generalized anxiety disorder (GAD) and panic disorder (PD) are disabling conditions, often comorbid with other anxiety disorders. The present study was aimed to assess prevalence and related disability of comorbid social phobia (SP) and obsessive-compulsive disorder (OCD) in 115 patients with GAD (57) or PD (58).

Methods: Patients were classified as having threshold, subthreshold, or no comorbidity, and related prevalence rates, as well as disability (Sheehan Disability Scale, SDS), were compared across diagnostic subgroups.

Results: SP and OCD comorbidities were present in 30.4% of the sample, with subthreshold comorbidities present at twice the rate of threshold ones (22.6% vs. 11.3%). Compared with GAD patients, PD patients showed significantly higher subthreshold and threshold comorbidity rates (27.6% and 13.8% vs. 17.5% and 8.8%, respectively). Comorbid PD patients had higher SDS scores than the comorbid and non-comorbid GAD subjects. The presence of threshold SP comorbidity was associated with the highest SDS scores.

Conclusions: SP and OCD comorbidities were found to be prevalent and disabling among GAD and PD patients, with higher subthreshold than threshold rates, and a negative impact on quality of life. Present findings stress the importance of a dimensional approach to anxiety disorders, the presence of threshold and subthreshold comorbidity being the rule rather than the exception.

Keywords: Anxiety disorders; disability; generalized anxiety disorder; panic disorder; subthreshold comorbidity; threshold comorbidity.

MeSH terms

  • Adult
  • Anxiety Disorders / epidemiology*
  • Comorbidity
  • Disability Evaluation
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Obsessive-Compulsive Disorder / epidemiology*
  • Panic Disorder / epidemiology*
  • Phobic Disorders / epidemiology*
  • Prevalence
  • Quality of Life / psychology
  • Young Adult