Anxiety syndromes and their relationship to depressive illness

The DSM-III categories of anxiety disorder are reviewed, and a study of anxiety symptoms in subjects with RDC-defined major depression is described. Anxiety appears to be common in major depression; 29% of the sample studied had a history of panic attacks, and moderate psychic anxiety was reported in 62%. Analysis by depressive subtypes showed no differences for the bipolar/unipolar distinction. However, significant differences in anxiety symptoms were seen in the primary vs. secondary and, more strikingly, endogenous vs. nonendogenous categories. The presence/severity of anxiety symptoms thus appears to be an important factor in the clinical management of major depression and may eventually serve as a guide to choosing among the increasing number of available antidepressant medications.