Learning Objectives
- Describe the comorbidity of generalized anxiety disorder.
- Describe the comorbidity of specific phobia.
- Describe the comorbidity of agoraphobia.
- Describe the comorbidity of social anxiety disorder.
- Describe the comorbidity of panic disorder.
Generalized anxiety disorder
There is a high comorbidity between generalized anxiety disorder and the other anxiety-related disorders, as well as unipolar depressive disorders. Comorbidity with substance use, neurodevelopmental, neurocognitive, psychotic, and conduct disorders is less common for those afflicted with generalized anxiety disorder. Generalized anxiety disorder is associated with higher levels of suicidal ideation and behavior and psychological autopsy studies reveal it is the most frequent anxiety disorder diagnosed in suicides (APA, 2022).
Specific phobia
Other anxiety disorders, depressive and bipolar disorders, substance-related disorders, and somatic symptom disorder are typically comorbid with specific phobia. Additionally, personality disorders, in particular dependent personality disorder, are comorbid. Specific phobia is associated with the transition from suicidal ideation to attempt (APA, 2022).
Agoraphobia
As with other anxiety disorders, common comorbid mental disorders include other anxiety disorders and depressive disorders. Agoraphobia is also comorbid with PTSD and alcohol use disorder. For those with comorbid major depressive disorder, the agoraphobia is more treatment-resistant compared to those with agoraphobia alone. About 15% of patients diagnosed with agoraphobia report suicidal thoughts or behavior (APA, 2022).
Social Anxiety Disorder
Among the most common comorbid diagnoses with a social anxiety disorder are other anxiety-related disorders, major depressive disorder, and substance-related disorders. The high comorbidity rate among anxiety-related disorders and substance-related disorders is likely connected to the efforts of self-medicating to deal with social fears. For example, an individual with social anxiety disorder may consume more alcohol in social settings in efforts to alleviate the anxiety of the social situation. The comorbidity with major depressive disorder may be due to the chronic social isolation associated with social anxiety disorder. Comorbidity has also been found with body dysmorphic disorder and avoidant personality disorder.
Panic disorder
Panic disorder rarely occurs in isolation, as 80% of individuals report symptoms of other anxiety disorders, major depressive disorder, bipolar I and bipolar II disorder, and possibly mild alcohol use disorder. Some individuals diagnosed with panic disorder also develop a substance-related disorder, likely as an attempt to treat their anxiety with alcohol or other substances. About 25% of patients report suicidal thoughts and the disorder may increase the risk for future suicidal behaviors but not deaths. (APA, 2022).
Unlike some of the other anxiety disorders, there is a high comorbidity with general medical symptoms. More specifically, individuals with panic disorder are more likely to report somatic symptoms such as dizziness, cardiac arrhythmias, COPD, asthma, irritable bowel syndrome, and hyperthyroidism (APA, 2022). The relationship between panic symptoms and these conditions is unclear.
Key Takeaways
You should have learned the following in this section:
- Many anxiety disorders are comorbid with one another.
- Other common comorbid disorders include depressive disorders and substance-related disorders.
- Agoraphobia has a high comorbidity with PTSD and panic disorder with general medical symptoms.
- Most anxiety disorders are associated with suicidal thoughts and behaviors, but not always deaths.
Review Questions
- What other disorders commonly occur with specific anxiety related disorders and why?
- What anxiety-related disorder has a high comorbidity with medical symptoms?
- What is the relationship of the disorders with suicidal ideation and attempts/behaviors? Be specific.
