Defining anxious depression: going beyond comorbidity
Open accessAbstract
OBJECTIVE: Since publication of the DSM-IV, there remains a group of patients with depression and anxiety symptoms who are not well classified. We therefore wanted to determine more accurately the type of patients best described by the term "anxious depression." We also wanted to review the literature to assess the most appropriate treatment(s) for these patients. METHOD: We surveyed the medical literature published after 1994 for all articles containing the relevant terms and assessed all possible articles in detail to determine those relevant to the diagnosis and those that involved relevant clinical studies. RESULTS: The term anxious depression can encompass 3 groups of patients: those with comorbid major depressive disorder (MDD) and an anxiety disorder, those with MDD but with subthreshold anxiety symptoms, and those with subthreshold depressive and subthreshold anxiety symptoms (also called mixed anxiety and depressive disorder). CONCLUSIONS: Based upon our literature review, we believe that the term anxious depression should only be used for the second group; that is, those patients with an MDD and subthreshold anxiety symptoms. From our literature review to determine the most appropriate treatment for this group of patients, it appears likely that drugs inhibiting the reuptake of both noradrenaline and serotonin may have greater clinical utility than single-action drugs such as the selective serotonin reuptake inhibitors (SSRIs). However, it is also clear that much more research needs to be undertaken in this important patient group so that we can better understand its prevalence, clinical features, and treatment.
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Various scales and different cutoff points to determine relevant anxiety symptoms have been used, resulting in heterogeneity in the dimensional definition of anxious depression.
“However, various scales and different cutoff points to determine relevant anxiety symptoms have been used, resulting in heterogeneity in the dimensional definition as well [2,3].”
From Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome (2018) · cites this paper as [3]
Various definitions for anxious depression are used across studies, making results not always directly comparable.
“Consequently, various definitions for anxious depression are being used across studies, making results not always directly comparable.”
From Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome (2018) · cites this paper as [3]
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- Authors
- Silverstone, P. H., & von Studnitz, E.
- Affiliations
- University of Alberta (CA)
- Integra-Pharm, Narberth, Pennsylvania
- Corresponding author
- Silverstone, Peter H
- ORCID
- Silverstone, Peter H
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2003-11
- Volume
- 48
- Issue
- 10
- Pages
- 675-680
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- OpenAlex
- W2145232823
- Cited by
- 57
- References
- 57
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 6 · 2017: 4 · 2016: 2 · 2015: 2 · 2014: 3 · 2013: 4 · 2012: 1
- FWCI
- 0.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- anxious depression, major depressive disorder, mixed anxiety-depressive disorder, comorbidities, diagnosis, treatment, selective serotonin reuptake inhibitors, DSM-IV
- MeSH terms
- Anxiety, Clinical Trials as Topic, Major Depressive Disorder, Humans, Comorbidity, Selective Serotonin Reuptake Inhibitors, Diagnostic and Statistical Manual of Mental Disorders
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