Search tips
Search criteria 


Logo of ijpsychHomeCurrent issueInstructionsSubmit article
Indian J Psychiatry. 2002 Jul-Sep; 44(3): 246–252.
PMCID: PMC2954395



In a sample of 94 panic patients, 43 patients (45.7%) had comorbid depression. In majority of patients, the comorbid depression was severe enough to be diagnosed as major depression. Panic patients with depression were more severely functionally impaired and had more generalized anxiety symptoms as compared to pure panic patients. There were no significant differences between panic patients with primary and secondary depression on any of the clinical variables. Findings from the present study are in agreement with earlier studies in that panic disorder comorbid with depression is a much more severe illness than pure panic disorder.

Keywords: Panic disorder, depression

Full Text

The Full Text of this article is available as a PDF (275K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Bowen RC, Kohout J. The relationship between agoraphobia and primary affective disorders. Can Psychiatr Assoc J. 1979 Jun;24(4):317–322. [PubMed]
  • Breier A, Charney DS, Heninger GR. Major depression in patients with agoraphobia and panic disorder. Arch Gen Psychiatry. 1984 Dec;41(12):1129–1135. [PubMed]
  • Buller R, Maier W, Benkert O. Clinical subtypes in panic disorder: their descriptive and prospective validity. J Affect Disord. 1986 Sep-Oct;11(2):105–114. [PubMed]
  • Cassano GB, Perugi G, Musetti L, Akiskal HS. The nature of depression presenting concomitantly with panic disorder. Compr Psychiatry. 1989 Nov-Dec;30(6):473–482. [PubMed]
  • Clancy J, Noyes R, Jr, Hoenk PR, Slymen DJ. Secondary depression in anxiety neurosis. J Nerv Ment Dis. 1978 Dec;166(12):846–850. [PubMed]
  • Endicott J, Spitzer RL, Fleiss JL, Cohen J. The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry. 1976 Jun;33(6):766–771. [PubMed]
  • Fawcett J, Kravitz HM. Anxiety syndromes and their relationship to depressive illness. J Clin Psychiatry. 1983 Aug;44(8 Pt 2):8–11. [PubMed]
  • Gorman JM, Coplan JD. Comorbidity of depression and panic disorder. J Clin Psychiatry. 1996;57 (Suppl 10):34–43. [PubMed]
  • Klerman GL. Overview of the Cross-National Collaborative Panic Study. Arch Gen Psychiatry. 1988 May;45(5):407–412. [PubMed]
  • Leckman JF, Merikangas KR, Pauls DL, Prusoff BA, Weissman MM. Anxiety disorders and depression: contradictions between family study data and DSM-III conventions. Am J Psychiatry. 1983 Jul;140(7):880–882. [PubMed]
  • Lesser IM, Rubin RT, Pecknold JC, Rifkin A, Swinson RP, Lydiard RB, Burrows GD, Noyes R, Jr, DuPont RL., Jr Secondary depression in panic disorder and agoraphobia. I. Frequency, severity, and response to treatment. Arch Gen Psychiatry. 1988 May;45(5):437–443. [PubMed]
  • Merikangas KR, Angst J, Eaton W, Canino G, Rubio-Stipec M, Wacker H, Wittchen HU, Andrade L, Essau C, Whitaker A, et al. Comorbidity and boundaries of affective disorders with anxiety disorders and substance misuse: results of an international task force. Br J Psychiatry Suppl. 1996 Jun;(30):58–67. [PubMed]
  • Munjack DJ, Moss HB. Affective disorder and alcoholism in families of agoraphobics. Arch Gen Psychiatry. 1981 Aug;38(8):869–871. [PubMed]
  • Noyes R., Jr The comorbidity and mortality of panic disorder. Psychiatr Med. 1990;8(2):41–66. [PubMed]
  • Noyes R, Jr, Reich J, Christiansen J, Suelzer M, Pfohl B, Coryell WA. Outcome of panic disorder. Relationship to diagnostic subtypes and comorbidity. Arch Gen Psychiatry. 1990 Sep;47(9):809–818. [PubMed]
  • Raskin M, Peeke HV, Dickman W, Pinsker H. Panic and generalized anxiety disorders. Developmental antecedents and precipitants. Arch Gen Psychiatry. 1982 Jun;39(6):687–689. [PubMed]
  • Reich J, Warshaw M, Peterson LG, White K, Keller M, Lavori P, Yonkers KA. Comorbidity of panic and major depressive disorder. J Psychiatr Res. 1993;27 (Suppl 1):23–33. [PubMed]
  • Robins LN, Wing J, Wittchen HU, Helzer JE, Babor TF, Burke J, Farmer A, Jablenski A, Pickens R, Regier DA, et al. The Composite International Diagnostic Interview. An epidemiologic Instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry. 1988 Dec;45(12):1069–1077. [PubMed]
  • Roy-Byrne PP, Stang P, Wittchen HU, Ustun B, Walters EE, Kessler RC. Lifetime panic-depression comorbidity in the National Comorbidity Survey. Association with symptoms, impairment, course and help-seeking. Br J Psychiatry. 2000 Mar;176:229–235. [PubMed]
  • Sartorius N, Ustün TB, Costa e Silva JA, Goldberg D, Lecrubier Y, Ormel J, Von Korff M, Wittchen HU. An international study of psychological problems in primary care. Preliminary report from the World Health Organization Collaborative Project on 'Psychological Problems in General Health Care'. Arch Gen Psychiatry. 1993 Oct;50(10):819–824. [PubMed]
  • Shear MK, Brown TA, Barlow DH, Money R, Sholomskas DE, Woods SW, Gorman JM, Papp LA. Multicenter collaborative panic disorder severity scale. Am J Psychiatry. 1997 Nov;154(11):1571–1575. [PubMed]
  • Stein MB, Tancer ME, Gelernter CS, Vittone BJ, Uhde TW. Major depression in patients with social phobia. Am J Psychiatry. 1990 May;147(5):637–639. [PubMed]
  • Thompson AH, Bland RC, Orn HT. Relationship and chronology of depression, agoraphobia, and panic disorder in the general population. J Nerv Ment Dis. 1989 Aug;177(8):456–463. [PubMed]
  • Uhde TW, Boulenger JP, Roy-Byrne PP, Geraci MF, Vittone BJ, Post RM. Longitudinal course of panic disorder: clinical and biological considerations. Prog Neuropsychopharmacol Biol Psychiatry. 1985;9(1):39–51. [PubMed]
  • VanValkenburg C, Akiskal HS, Puzantian V, Rosenthal T. Anxious depressions. Clinical, family history, and naturalistic outcome--comparisons with panic and major depressive disorders. J Affect Disord. 1984 Feb;6(1):67–82. [PubMed]
  • Vollrath M, Angst J. Outcome of panic and depression in a seven-year follow-up: results of the Zurich study. Acta Psychiatr Scand. 1989 Dec;80(6):591–596. [PubMed]
  • Walker EA, Katon WJ, Russo J, Von Korff M, Lin E, Simon G, Bush T, Ludman E, Unützer J. Predictors of outcome in a primary care depression trial. J Gen Intern Med. 2000 Dec;15(12):859–867. [PMC free article] [PubMed]
  • Warshaw MG, Dolan RT, Keller MB. Suicidal behavior in patients with current or past panic disorder: five years of prospective data from the Harvard/Brown Anxiety Research Program. Am J Psychiatry. 2000 Nov;157(11):1876–1878. [PubMed]
  • Wittchen HU, Kessler RC, Pfister H, Lieb M. Why do people with anxiety disorders become depressed? A prospective-longitudinal community study. Acta Psychiatr Scand Suppl. 2000;(406):14–23. [PubMed]

Articles from Indian Journal of Psychiatry are provided here courtesy of Wolters Kluwer -- Medknow Publications