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Defining anxious depression: going beyond comorbidity.

Peter H Silverstone1, Erica von Studnitz

  • 1Departments of Psychiatry and Neuroscience, 1E1.07 Mackenzie Center, University of Alberta, Edmonton, AB T6G 2B7. peter.silverstone@ualberta.ca

Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|December 17, 2003
PubMed
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Anxious depression describes patients with major depressive disorder and subthreshold anxiety symptoms. Treatments like serotonin-norepinephrine reuptake inhibitors may be more effective than SSRIs, but more research is needed.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Pharmacology

Background:

  • The classification of patients with both depression and anxiety symptoms remains challenging post-DSM-IV.
  • A specific diagnostic category for
  • anxious depression
  • is not well-defined, leading to diagnostic ambiguity.
  • Existing diagnostic criteria may not fully capture the complexity of these presentations.

Purpose of the Study:

  • To accurately define the patient profile best described by the term "anxious depression."
  • To review existing literature to identify optimal treatment strategies for this patient group.

Main Methods:

  • A comprehensive literature search was conducted for articles published after 1994.
  • Relevant articles were assessed for diagnostic criteria and clinical studies related to anxious depression.

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Main Results:

  • "Anxious depression" can refer to three patient groups: comorbid major depressive disorder (MDD) and anxiety disorder, MDD with subthreshold anxiety, or subthreshold depressive and anxiety symptoms (mixed anxiety and depressive disorder).
  • The study suggests reserving "anxious depression" for patients with MDD and subthreshold anxiety.

Conclusions:

  • The term "anxious depression" should be specifically applied to patients diagnosed with major depressive disorder (MDD) exhibiting subthreshold anxiety symptoms.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) may offer greater clinical utility than selective serotonin reuptake inhibitors (SSRIs) for this group.
  • Further research is essential to understand the prevalence, clinical characteristics, and effective treatments for patients with anxious depression.