Comorbidities associated with depression have been researched in a number of contexts. However, the epidemiological situation in clinical practice is understudied, especially in the post-Communist Central and Eastern Europe region. The aim of this study was to assess physical comorbidities in depression, and to identify whether there are increased odds of physical comorbidities associated with co-occurring depressive and anxiety disorders. Data on 4264 patients aged 18-98 were collected among medical doctors in the Czech Republic between 2010 and 2011. Descriptive statistics were calculated and multiple logistic regressions were performed to assess comorbidities among patients with depressive disorder. There were 51.29% of those who have a physical comorbidity, and 45.5% of those who have a comorbid anxiety disorders among patients treated with depression in Czech primary care. Results of logistic regressions show that odds of having pain, hypertension or diabetes mellitus are particularly elevated at those who have co-occurring depressive and anxiety disorder. Our findings demonstrate that comorbidities associated with depressive disorders are highly prevalent in primary health care practice, and that physical comorbidities are particularly frequent among those with co-occurring depressive and anxiety disorders.

3rd Medical Faculty Charles University Ruská 2411 87 100 00 Prague Czech Republic

Institute of Psychiatry Psychology and Neuroscience King's College London 16 De Crespigny Park London SE5 8AF UK

KRKA Čr S r o Mezibranská 579 7 110 00 Prague Czech Republic

National Institute of Mental Health Topolová 748 250 67 Klecany Czech Republic

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Nutt D., Argyropoulos S., Hood S., Potokar J. Generalized anxiety disorder: A comorbid disease. Eur. Neuropsychopharmacol. 2006 doi: 10.1016/j.euroneuro.2006.04.003. PubMed DOI

Braam A.W., Copeland J.R., Delespaul P.A., Beekman A.T., Como A., Dewey M., Fichter M., Holwerda T.J., Lawlor B.A., Lobo A., et al. Depression, subthreshold depression and comorbid anxiety symptoms in older Europeans: Results from the EURODEP concerted action. J. Affect Disord. 2014;155:266–272. doi: 10.1016/j.jad.2013.11.011. PubMed DOI

Fava M., Rankin M.A., Wright E.C., Alpert J.E., Nierenberg A.A., Pava J., Rosenbaum J.F. Anxiety disorders in major depression. Compr. Psychiatry. 2000 doi: 10.1016/S0010-440X(00)90140-8. PubMed DOI

King-Kallimanis B., Gum A.M., Kohn R. Comorbidity of depressive and anxiety disorders for older Americans in the national comorbidity survey-replication. Am. J. Geriatr. Psychiatry. 2009;17:782–792. doi: 10.1097/JGP.0b013e3181ad4d17. PubMed DOI

Zimmerman M., McDermut W., Mattia J.I. Frequency of anxiety disorders in psychiatric outpatients with major depressive disorder. Am. J. Psychiatry. 2000;157:1337–1340. doi: 10.1176/appi.ajp.157.8.1337. PubMed DOI

Gorman J.M. Comorbid depression and anxiety spectrum disorders. Depress Anxiety. 1996;4:160–168. doi: 10.1002/(SICI)1520-6394(1996)4:4<160::AID-DA2>3.0.CO;2-J. PubMed DOI

Merikangas K.R., Zhang H., Avenevoli S., Acharyya S., Neuenschwander M., Angst J. Longitudinal trajectories of depression and anxiety in a prospective community study. Arch. Gen. Psychiatry. 2003;60:993–1000. PubMed

Sherbourne C.D., Wells K.B. Course of depression in patients with comorbid anxiety disorders. J. Affect. Disord. 1997;43:245–250. doi: 10.1016/S0165-0327(97)01442-0. PubMed DOI

Vogelzangs N., Seldenrijk A., Beekman A.T., van Hout H.P., de Jonge P., Penninx B.W. Cardiovascular disease in persons with depressive and anxiety disorders. J. Affect. Disord. 2010;125:241–248. doi: 10.1016/j.jad.2010.02.112. PubMed DOI PMC

Scott K., Bruffaerts R., Tsang A., Ormel J., Alonso J., Angermeyer M., Benjet C., Bromet E., de Girolamo G., de Graaf R., et al. Depression–anxiety relationships with chronic physical conditions: Results from the World Mental Health Surveys. J. Affect. Disord. 2007;103:113–120. doi: 10.1016/j.jad.2007.01.015. PubMed DOI

Stein D.J., Aguilar-Gaxiola S., Alonso J., Bruffaerts R., de Jonge P., Liu Z., Miguel Caldas-de-Almeida J., O’Neill S., Viana M.C., Al-Hamzawi A.O., et al. Associations between mental disorders and subsequent onset of hypertension. Gen. Hosp. Psychiatry. 2014;36:142–149. doi: 10.1016/j.genhosppsych.2013.11.002. PubMed DOI PMC

Bhattacharya R., Shen C., Sambamoorthi U. Excess risk of chronic physical conditions associated with depression and anxiety. BMC Psychiatry. 2014 doi: 10.1186/1471-244X-14-10. PubMed DOI PMC

Roy T., Lloyd C.E. Epidemiology of depression and diabetes: A systematic review. J. Affect. Disord. 2012 doi: 10.1016/S0165-0327(12)70004-6. PubMed DOI

Romera I., Fernandez-Perez S., Montejo A.L., Caballero F., Caballero L., Arbesu J.A., Gilaberte I. Generalized anxiety disorder, with or without co-morbid major depressive disorder, in primary care: Prevalence of painful somatic symptoms, functioning and health status. J. Affect. Disord. 2010;127:160–168. doi: 10.1016/j.jad.2010.05.009. PubMed DOI

Petersen T., Andreotti C.F., Chelminski I., Young D., Zimmerman M. Do comorbid anxiety disorders impact treatment planning for outpatients with major depressive disorder? Psychiatry Res. 2009 doi: 10.1016/j.psychres.2008.10.036. PubMed DOI

Forsman A.K., Ventus D.B., van der Feltz-Cornelis C.M., Wahlbeck K. Public mental health research in Europe: A systematic mapping for the ROAMER project. Eur. J. Public Health. 2014;24:955–960. doi: 10.1093/eurpub/cku055. PubMed DOI

Patten S.B., Williams J.V., Lavorato D.H., Modgill G., Jette N., Eliasziw M. Major depression as a risk factor for chronic disease incidence: Longitudinal analyses in a general population cohort. Gen. Hosp. Psychiatry. 2008;30:407–413. doi: 10.1016/j.genhosppsych.2008.05.001. PubMed DOI

Beaudet M.P. Depression. Health Rep. 1996;7:11–25. PubMed

Patten S.B. Long-term medical conditions and major depression in a Canadian population study at waves 1 and 2. J. Affect. Disord. 2001 doi: 10.1016/S0165-0327(00)00186-5. PubMed DOI

Kessler R.C., Crum R.M., Warner L.A., Nelson C.B., Schulenberg J., Anthony J.C. Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Arch. Gen. Psychiatry. 1997;54:313–321. doi: 10.1001/archpsyc.1997.01830160031005. PubMed DOI

Katon W., Von K.M., Lin E., Lipscomb P., Russo J., Wagner E., Polk E. Distressed high utilizers of medical care. DSM-III-R diagnoses and treatment needs. Gen. Hosp. Psychiatry. 1990;12:355–362. doi: 10.1016/0163-8343(90)90002-T. PubMed DOI

Hirschfeld R.M. The comorbidity of major depression and anxiety disorders: Recognition and management in primary care. Prim. Care Companion J. Clin. Psychiatry. 2001;3:244–254. doi: 10.4088/PCC.v03n0609. PubMed DOI PMC

Kessler R.C., Nelson C.B., McGonagle K.A., Liu J., Swartz M., Blazer D.G. Comorbidity of DSM-III-R major depressive disorder in the general population: Results from the US National Comorbidity Survey. Br. J. Psychiatry Suppl. 1996;30:17–30. PubMed

Olfson M., Fireman B., Weissman M.M., Leon A.C., Sheehan D.V., Kathol R.G., Hoven C., Farber L. Mental disorders and disability among patients in a primary care group practice. Am. J. Psychiatry. 1997;154:1734–1740. doi: 10.1176/ajp.154.12.1734. PubMed DOI

Brown L.C., Majumdar S.R., Newman S.C., Johnson J.A. History of depression increases risk of type 2 diabetes in younger adults. Diabet. Care. 2005;28:1063–1067. doi: 10.2337/diacare.28.5.1063. PubMed DOI

Eaton W.W., Armenian H., Gallo J., Pratt L., Ford D.E. Depression and risk for onset of type II diabetes. A prospective population-based study. Diabet. Care. 1996;19:1097–1102. doi: 10.2337/diacare.19.10.1097. PubMed DOI

DeJean D., Giacomini M., Vanstone M., Brundisini F. Patient experiences of depression and anxiety with chronic disease: A systematic review and qualitative meta-synthesis. Ont. Health Technol. Assess Ser. 2013;13:1–33. PubMed PMC

Henningsen P., Zimmermann T., Sattel H. Medically unexplained physical symptoms, anxiety, and depression: A meta-analytic review. Psychosom. Med. 2003;65:528–533. doi: 10.1097/01.PSY.0000075977.90337.E7. PubMed DOI

Gureje O. Comorbidity of pain and anxiety disorders. Curr. Psychiatry Rep. 2008;10:318–322. doi: 10.1007/s11920-008-0051-0. PubMed DOI

Gureje O., von Korff M., Kola L., Demyttenaere K., He Y., Posada-Villa J., Angermeyer M.C., Levinson D., de Girolamo G., Uda H., et al. The relation between multiple pains and mental disorders: Results from the World Mental Health Surveys. Pain. 2008;135:82–91. PubMed

Van Dijk G., van Heijningen S., Reijne A.C., Nyakas C., van der Zee E.A., Eisel U.L. Integrative neurobiology of metabolic diseases, neuroinflammation, and neurodegeneration. Front. Neurosci. 2015 doi: 10.3389/fnins.2015.00173. PubMed DOI PMC

Prince M.J., Harwood R.H., Thomas A., Mann A.H. A prospective population-based cohort study of the effects of disablement and social milieu on the onset and maintenance of late-life depression. The Gospel Oak Project VII. Psychol. Med. 1998;28:337–350. doi: 10.1017/S0033291797006478. PubMed DOI

Cohen S., Rodriquez M.S. Pathways linking affective disturbances and physical disorders. Health Psychol. 1995;14:374–380. doi: 10.1037/0278-6133.14.5.374. PubMed DOI

Pickering T.G. Mental stress as a causal factor in the development of hypertension and cardiovascular disease. Curr. Hypertens. Rep. 2001;3:249–254. doi: 10.1007/s11906-001-0047-1. PubMed DOI

Horacek J., Kuzmiakova M., Hoschl C., Andel M., Bahbonh R. The relationship between central serotonergic activity and insulin sensitivity in healthy volunteers. Psychoneuroendocrinology. 1999;24:785–797. doi: 10.1016/S0306-4530(99)00026-8. PubMed DOI

Brunerova L., Potockova J., Horacek J., Suchy J., Andel M. Central dopaminergic activity influences metabolic parameters in healthy men. Neuroendocrinology. 2013;97:132–138. doi: 10.1159/000338405. PubMed DOI