Relationship of anxiety and depression

There has been considerable controversy regarding the relationship between depression and anxiety. We review briefly the descriptive, longitudinal, genetic, biological, and treatment response data indicating that there is overlap between depression and anxiety. Several possible models are explored that provide different conceptions of how this relationship may best be understood: (1) that there are a variety of more or less discrete, but sometimes coexisting, syndromes within the spectrum of anxiety and depression; (2) that symptoms of depression and anxiety represent different external manifestations of a more basic underlying cause; (3) that one condition may predispose to the other; (4) that the association may be due to artifactual definitional overlap, particularly since the instruments used to measure depression and anxiety share so many items. All these propositions are supported. An important, practical question is discussed--should the mixed anxiety/depressive disorder that has been suggested by ICD-10 be included in DSM-IV?