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An examination of generalized anxiety disorder and dysthymic disorder by latent class analysis

Published online by Cambridge University Press:  11 September 2013

D. Rhebergen ,
I. M. van der Steenstraten ,
M. Sunderland ,
R. de Graaf ,
M. ten Have ,
F. Lamers ,
B. W. J. H. Penninx  and
G. Andrews
D. Rhebergen*
Affiliation:
Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands GGZ inGeest, Amsterdam, The Netherlands
I. M. van der Steenstraten
Affiliation:
Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands
M. Sunderland
Affiliation:
Clinical Research Unit for Anxiety and Depression (CRUfAD), University of New South Wales, Sydney, NSW, Australia
R. de Graaf
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
M. ten Have
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
F. Lamers
Affiliation:
Genetic Epidemiological Research Branch, National Institute of Mental Health, Bethesda, MD, USA
B. W. J. H. Penninx
Affiliation:
Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands GGZ inGeest, Amsterdam, The Netherlands
G. Andrews
Affiliation:
Clinical Research Unit for Anxiety and Depression (CRUfAD), University of New South Wales, Sydney, NSW, Australia
*
* Address for correspondence: D. Rhebergen, M.D., Ph.D., VU University Medical Center Amsterdam, Amsterdam, The Netherlands. (Email: d.rhebergen@ggzingeest.nl)
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Abstract

Background

The nosological status of generalized anxiety disorder (GAD) versus dysthymic disorder (DD) has been questioned. The aim of this study was to examine qualitative differences within (co-morbid) GAD and DD symptomatology.

Method

Latent class analysis was applied to anxious and depressive symptomatology of respondents from three population-based studies (2007 Australian National Survey of Mental Health and Wellbeing; National Comorbidity Survey Replication; and Netherlands Mental Health Survey and Incidence Study-2; together known as the Triple study) and respondents from a multi-site naturalistic cohort [Netherlands Study of Depression and Anxiety (NESDA)]. Sociodemographics and clinical characteristics of each class were examined.

Results

A three-class (Triple study) and two-class (NESDA) model best fitted the data, reflecting mainly different levels of severity of symptoms. In the Triple study, no division into a predominantly GAD or DD co-morbidity subtype emerged. Likewise, in spite of the presence of pure GAD and DD cases in the NESDA sample, latent class analysis did not identify specific anxiety or depressive profiles in the NESDA study. Next, sociodemographics and clinical characteristics of each class were examined. Classes only differed in levels of severity.

Conclusions

The absence of qualitative differences in anxious or depressive symptomatology in empirically derived classes questions the differentiation between GAD and DD.

Keywords

Dysthymiageneralized anxiety disorderlatent class analysisnosology
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 8 , June 2014 , pp. 1701 - 1712
Copyright
Copyright © Cambridge University Press 2013 

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