The Canadian Network for Mood and Anxiety Treatments (Canmat) Task Force Recommendations for the Management of Patients with Mood Disorders and Comorbid Anxiety Disorders
Abstract
Background Comorbid mood and anxiety disorders are commonly seen in clinical practice. The goal of this article is to review the available literature on the epidemiologic, etiologic, clinical, and management aspects of this comorbidity and formulate a set of evidence- and consensus-based recommendations. This article is part of a set of Canadian Network for Mood and Anxiety Treatments (CANMAT) Comorbidity Task Force papers. Methods We conducted a PubMed search of all English-language articles published between January 1966 and November 2010. The search terms were bipolar disorder and major depressive disorder, cross-referenced with anxiety disorders/symptoms, panic disorder, agoraphobia, generalized anxiety disorder, social phobia, obsessive-compulsive disorder, and posttraumatic stress disorder . Levels of evidence for specific interventions were assigned based on a priori determined criteria, and recommendations were developed by integrating the level of evidence and clinical opinion of the authors. Results Comorbid anxiety symptoms and disorders have a significant impact on the clinical presentation and treatment approach for patients with mood disorders. A set of recommendations are provided for the management of bipolar disorder (BD) with comorbid anxiety and major depressive disorder (MDD) with comorbid anxiety with a focus on comorbid posttraumatic stress disorder, use of cognitive-behavioral therapy across mood and anxiety disorders, and youth with mood and anxiety disorders. Conclusions Careful attention should be given to correctly identifying anxiety comorbidities in patients with BD or MDD. Consideration of evidence- or consensus-based treatment recommendations for the management of both mood and anxiety symptoms is warranted.
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Insufficient evidence is available to support a positive or negative effect of anxiety symptoms or disorders on depression outcomes.
“Insufficient evidence is available to support a positive or negative effect of anxiety symptoms or disorders on depression outcomes”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [21]
CBT may be more effective than other treatments for depression with comorbid anxiety symptoms or disorders.
“but CBT may be more effective than other treatments.”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [21]
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Effects of Duloxetine in Treatment-Refractory Men with Posttraumatic Stress Disorder
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Mood and anxiety spectrum as a means to identify clinically relevant subtypes of bipolar I disorder1
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Kennedy, S. H., Lam, R. W., McIntyre, R. S., Tourjman, S. V., Bhat, V., Blier, P., Hasnain, M., Jollant, F., Levitt, A. J., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659417 · Cited by 1,150 · see citing works
Self-citationMalhi, G. S., Bassett, D., Boyce, P., Bryant, R., Fitzgerald, P. B., Fritz, K., Hopwood, M., Lyndon, B., Mulder, R., Murray, G., et al. (2015) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415617657 · Cited by 842 · see citing works
Parikh, S. V., Quilty, L. C., Ravitz, P., Rosenbluth, M., Pavlova, B., Grigoriadis, S., Velyvis, V., Kennedy, S. H., Lam, R. W., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659418 · Cited by 562 · see citing works
- Authors
- Schaffer, A., McIntosh, D., Goldstein, B. I., Rector, N. A., McIntyre, R. S., Beaulieu, S., Swinson, R., & Yatham, L. N.
- Affiliations
- Sunnybrook Health Science Centre (CA)
- University of British Columbia (CA)
- University of Toronto (CA)
- University Health Network (CA)
- Douglas Mental Health University Institute (CA)
- McMaster University (CA)
- Corresponding author
- Schaffer, Ayal
- Venue
- Annals of Clinical Psychiatry
- Publisher
- SAGE Publications
- Published
- 2012-02
- Volume
- 24
- Issue
- 1
- Pages
- 6-22
- ISSN
- 1040-1237 (ISSN-L)
- 1547-3325
- OpenAlex
- W7081532659
- Cited by
- 7
- References
- 216
- Citations by year
- 2026: 2 · 2025: 3 · 2022: 1 · 2012: 1
- FWCI
- 0.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Clinical Psychiatry (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- mood disorders, anxiety disorders, comorbidities, bipolar disorder, major depressive disorder, post-traumatic stress disorder, cognitive behavioral therapy, youth mental health, treatment guidelines, panic disorder, agoraphobia, generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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