Coexisting depression and anxiety: special diagnostic and treatment issues

Anxiety and depression often coexist in the clinical setting. Using panic disorder as an example, the author presents an overview of the prevalence, familial aspects, and long- and short-term outcomes of such comorbid disorders. Evidence regarding the diagnostic category of mixed anxiety-depression is also reviewed. On the basis of the limited available data, the author advances possible treatment strategies for treating patients with comorbid depression and anxiety disorders. Combined pharmacologic therapies may be indicated to optimize treatment for some patients. The review underscores the need for treatment studies in patients with depression and coexisting anxiety.