Pergamon 0005-7967(93)E0028-4 Behav. Res. Ther. Vol. 33, No. 1, pp. 55-56, 1995 Copyright © 1994 Elsevier Science Ltd Printed in Great Britain. All fights reserved 0005-7967/95 $7.00+ 0.00 CASE HISTORIES AND SHORTER COMMUNICATIONS Pathological worry in major depression: a preliminary report VLADAN STARCEVIC Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM 87131, U.S.A. (Received I September 1993; received for publication) Summary--Forty-nine Ss with the DSM-III-R generalized anxiety disorder (GAD) and 32 Ss with the DSM-III-R major depressive episode (MDE) were administered the Penn State Worry Questionnaire (PSWQ) in order to assess the frequency and severity of worrying. The PSWQ scores were almost equally elevated in Ss with GAD and MDE, indicating that high PSWQ scores may not be specific for the diagnosis of GAD. This finding also suggests that except for the uncontrollability of worry, which was not measured by the PSWQ, there may be no difference in the process of pathological worrying between Ss with GAD and MDE. The domains of worry may or may not be similar in Ss with GAD and MDE, but the experiences associated with them are likely to be different, due to different cognitive schemata in anxiety and depression. Finally, the phenomenological presentation of pathological worry may also differ in these two conditions, which calls for further research in this area. INTRODUCTION The uncontrollability, high frequency and interference with functioning have been postulated as the most important dimensions of worry in generalized anxiety disorder, GAD (Borkovec, Shadick & Hopkins, 1991). However, the uncontrollability of worry was "singled out" as the main feature of pathological worry (Borkovec et al., 1991; Craske, Rapee, Jackel & Barlow, 1989), and it found its way as one of the diagnostic criteria for GAD in the DSM-IV draft criteria (American Psychiatric Association, Task Force on DSM-IV, 1993). While such a conceptualization of pathological worry is likely to help in identifying Ss with GAD, it is not sufficiently known how specific pathological worry is for the diagnosis of GAD and for the concept of chronic anxiety in general. One study (Brown, Antony & Barlow, 1992) has suggested that a high level of pathological worry, as measured by the Penn State Worry Questionnaire, PSWQ (Meyer, Miller, Metzger & Borkovec, 1990), distinguishes reliably Ss with GAD from Ss with other anxiety disorders, including those with obsessive-compulsive disorder. The aim of this study was to extend the research on pathological worry to S s with other forms of psychopathology. More precisely, we wanted to examine the degree of pathological worry, as measured by the PSWQ, in Ss with major depression, because of certain similarities and apparently much overlap between pathological worry occurring in GAD and depression-related thought processes. METHOD Subjects Ss were evaluated for two drug studies at the Psychiatry Research Center of the University of New Mexico. One study was designed for Ss with the DSM-III-R diagnosis of GAD, and the other was a treatment study of Ss with the DSM-III-R diagnosis of major depressive episode (MDE). Ss were recruited through newspaper advertisements, referrals from other colleagues, fliers and word of mouth. All Ss received diagnoses on the basis of the Structured Clinical Interview for DSM-III-R (Spitzer, Williams, Gibbon & First, 1990). Ss who were recruited for the GAD study were excluded if they were also diagnosed with current MDE. On the other hand, although the presence of GAD was not an exclusion criterion for participation in the pharmacological treatment study of Ss with MDE, we excluded from analyses all Ss who were diagnosed with GAD, in addition to MDE. The rationale was to eliminate a possible confounding influence of comorbid GAD on the measurement of worry in Ss with MDE. Because of the diagnostic hierarchical considerations, Ss were excluded from the study if they had a lifetime history of schizophrenia, bipolar disorder, delusional disorder, organic mental syndrome, or any other psychotic disorder. Moreover, Ss with panic disorder, social phobia and current psychoactive substance abuse or dependence were also excluded. There were 49 Ss with a diagnosis of GAD, 38 (77.6%) of whom were women and 11 (22.4%) of whom were men. Their mean age was 43.67 yr (SD = 10.01). The group consisted of 37 (75.5%) non-Hispanic whites, I 1 (22.4%) Ss who identified themselves as Hispanics or had Spanish surnames, and 1 (2. I%) Asian-American. The MDE group consisted of 32 Ss, with 22 (68.8%) women and 10 (31.2%) men. The mean age of Ss with MDE was 40.75 yr (SD = 11.81), and their ethnic composition was as follows: 21 (65.6%) non-Hispanic whites and 11 (34.4%) Hispanics. There were no significant differences between the subjects with GAD and MDE in terms of male-to-female ratio, current mean age and ethnic composition. BRT 33:1--E 55