18.6.12

Anxiety and Depression Study Results




Anxiety and Depression Co-morbidity Rates
Michael Bell
Carlow University

















Anxiety and Depression Co-Morbidity Rates
Introduction
According to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association. [APA], 2000) depression is defined as a mood disorder.  The mood during a depressive episode is often described as sad, hopeless, and discouraged.  Other symptoms of depression can include insomnia or increased need for sleep, lack of interest in things that were once found pleasurable, low sex drive, decreased or increased appetite, agitation, tiredness, and fatigue (American Psychiatric Association, 2000).
Anxiety is defined as “an abnormal and overwhelming sense of apprehension and fear often marked by physiological signs (as sweating, tension, and increased pulse), by doubt concerning the reality and nature of the threat, and by self-doubt about one's capacity to cope with it” (Merriam-Webster's Collegiate Dictionary (11th edition), n.d., pg.107).  The DSM- IV states that the criterion for Generalized Anxiety Disorder (GAD) includes excessive anxiety and worry which occurs for at least 6 months.  GAD is characterized by the subject finding it difficult to control the worry and it typically presents the following symptoms: restlessness, fatigue, trouble concentrating, muscle tension, insomnia, and irritability (American Psychiatric Association, 2000).
Narrow, Rae, & Rieger, 1988 found that anxiety affects nearly 19 million Americans. A second study suggests that the incidence rate of anxiety is nine cases per 1000 persons per year (Murphy, Oliver, Monson, Sobol, & Leighton, 1988). The DSM –IV suggests that anxiety disorders are one of the most prevalent disorders diagnosed (American Psychiatric Association, 2000).
Anxiety and depression, if left untreated, can lead to serious psychological and health consequences. Untreated depression can increase the chance of risky behavior such as drug or alcohol addiction, can create issues with relationships, affect job performance, make it difficult to overcome serious illnesses, and even result in suicide (Liew, 2012).  A recent study suggests that the odds of having at least two chronic health conditions increases with the level of depression (Liew, 2012).  Rehna, Hanef, and Tariq,2012 found that cognitive errors have significant positive relationship with anxiety in both depressed and non-depressed samples. The results showed that depressed participants exhibited numerous types of cognitive errors.
 Studies suggest that cognitive behavioral therapy is very effective in the treatment of depression and anxiety and may prevent mildly depressed individuals from progressing to advanced stages of depression (American Psychological Association, 2010). Other treatment options for anxiety and depression include systematic desensitization, psychotherapy, and medication (American Psychological Association, 1997.)
 A recent study suggests that in 57% of people who have depression, anxiety disorders preceded the depression and that in 18%, depression preceded their anxiety disorders disorder ( Lamers, van Oppen, Comijs, Smit, Spinhoven, van Balkom, & Penninx, 2011).
There is also a suggestion of comorbidity with depression. Another recent study found that of subjects with a depressive disorder, 67% had a current and 75% had a lifetime comorbid anxiety disorder. Of subjects with a current anxiety disorder, 63% had a current and 81% had a lifetime depressive disorder ( Lamers et. al, 2011).
The purpose of this study was to examine the relationship between anxiety and depression.
Methods
Participants
            Ninety-four friends and acquaintances of graduate students in a research methods class participated in the study. Participants were collected by a sample of convenience.  All participants were over the age of eighteen.  Participants had no known mental health concerns.
Instruments
            This study used the Costello-Comrey Depression and Anxiety Scales (CCDAS; Costello & Comrey, 1967). The purpose of the CCDAS is to measure anxiety and depression.  “The depression scale [of the CCDAS] has excellent internal consistency, with split-half reliabilities of .90; split-half reliability for the anxiety scale was .70” (Costello & Comrey, 1967, pg. 213). The CCDAS has fair concurrent validity.  “Its anxiety scale is correlated with the Taylor Manifest Anxiety Scales and the depression scale is correlated with the depression scale of the MMPI. There is a small to moderate correlation between the CCDAS and social desirability, suggesting some response bias may be present” (Costello & Comrey, 1967, pg. 213).
Procedures
Sixteen graduate students in a research methods class approached friends and acquaintances using a sample of convenience. Participants had no known health concerns and were age eighteen or older. Participants were provided with informed consent.  Participation in the study was used as consent. Participants were given the CCDAS and were instructed to complete it to the best of their ability. Students collected the CCDAS in a manner to insure confidentiality and anonymity. Scores were calculated according to the instructions provided.
Results
            Data was analyzed using a software package that calculated the Pearson correlation coefficient. The results of that analysis revealed a moderate relationship between depression and anxiety (r=0.41, p=.01, two tailed).  The results indicated a significant finding for this study of ninety-seven participants.
Discussion
            This study examined the relationship between depression and anxiety using a sample of convenience of ninety-seven participants. The results revealed a moderate relationship between depression and anxiety that was significant (r=0.41, p=.01, two tailed).
            The results of this study are somewhat consistent with previous research. Numerous prior research studies suggest that there is a strong positive relationship between anxiety and depression. Murphy, Oliver, Monson, Sobol & Leighton, 1988, found that nearly 50 percent of all depression cases also had anxiety associated with them. This study found a positive relationship with only a seventeen percent co-morbidity rate.         
            The limitations of this study include a small sample size, and a sample of convenience.  Participants were only administered one test per subject.  It is unknown if the participant’s anxiety or depression was due to situational factors because the measurement was used at one point in time.
            Future research should use a larger sample size as well as a random sample, and multiple measurements across time to attain a more accurate measurement of anxiety and depression.
            This study examined the relationship between depression and anxiety using a sample of convenience of ninety-seven participants. The results revealed a moderate relationship between depression and anxiety that was significant (r=0.41, p=.01, two tailed).



References
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental
            Disorders (Revised 4th ed.). Washington, DC: Author.
American Psychological Association (1997). Understanding depression and effective treatment.  
            Washington, DC: Author.
Costello, C.G. and Comrey, A.L. (1967). Scales for measuring depression and anxiety, The
            Journal of Psychology, 66, 303-313.
Lamers, F., van Oppen, P., Comijs, H. C., Smit, J. H., Spinhoven, P., van Balkom, A. M., &
            Penninx, B. H. (2011). Comorbidity patterns of anxiety and depressive disorders in
            A large cohort study: The Netherlands Study of Depression and Anxiety (NESDA).
Liew, H. (2012). Depression and Chronic Illness: A test of Competing Hypothesis. Journal Of  
            Health Psychology, 17(1), 100-109.
Merriam-Webster’s Collegiate Dictionary (11th ed.). (2005). Springfield, MA: Merriam Webster.
Murphy, J. M., Oliver, D. C., Monson, R. R., Sobol, A. M., & Leighton, A. H. (1988). Incidence
            Of Depression and Anxiety: The Stirling County Study. American Journal of Public
            Health, 78(5), 534-540.
Narrow, W. E., Rae, D. S., Reiger, D.A., NIMH epidemiology note: prevalence of anxiety
            disorders. One-year prevalence best estimates calculated from ECA and NCS data.
            Population estimates based on U. S. Census estimated residential population age 18
            to 54 on July 1, 1998. Unpublished.
Rehna, T., Hanif, R., & Tariq, S. (2012). Cognitive Errors and Anxiety: A Comparison of
            Depresed and Non-Depressed Adolescents. European Journal Of Social
            Sceince., 27 (2-4), 309-318.




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