Cited by 663Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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The Comorbidity of Major Depression and Anxiety Disorders: Recognition and Management in Primary Care

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Hirschfeld, Robert M. A.·2001·The Primary Care Companion For CNS Disorders

DOI 10.4088/pcc.v03n0609PMC PMC181193

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Abstract

BACKGROUND: Depressive and anxiety disorders commonly occur together in patients presenting in the primary care setting. Although recognition of individual depressive and anxiety disorders has increased substantially in the past decade, recognition of comorbidity still lags. The current report reviews the epidemiology, clinical implications, and management of comorbidity in the primary care setting. METHOD: Literature was reviewed by 2 methods: (1) a MEDLINE search (1980-2001) using the key words depression, depressivedisorders, and anxietydisorders; comorbidity was also searched with individual anxiety diagnoses; and (2) direct search of psychiatry, primary care, and internal medicine journals over the past 5 years. RESULTS: Between 10% and 20% of adults in any given 12-month period will visit their primary care physician during an anxiety or depressive disorder episode (although typically for a nonpsychiatric complaint); more than 50% of these patients suffer from a comorbid second depressive or anxiety disorder. The presence of depressive/anxiety comorbidity substantially increases medical utilization and is associated with greater chronicity, slower recovery, increased rates of recurrence, and greater psychosocial disability. Typically, long-term treatment is indicated, although far less research is available to guide treatment decisions. Selective serotonin reuptake inhibitor antidepressants are the preferred treatment based on efficacy, safety, and tolerability criteria. Knowledge of their differential clinical and pharmacokinetic profiles can assist in optimizing treatment. CONCLUSION: Increased recognition of the high prevalence and negative psychosocial impact of depression and anxiety disorder comorbidity will lead to more effective treatment. While it is hoped that early and effective intervention will yield long-term benefits, research is needed to confirm this.

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Authors: Hirschfeld, R. M. A.
Affiliations: The University of Texas Medical Branch at Galveston (US)
Corresponding author: Hirschfeld, Robert M. A.
Venue: The Primary Care Companion For CNS Disorders
Publisher: Physicians Postgraduate Press, Inc
Published: 2001-12-01
Volume: 3
Issue: 6
Pages: 244-254
ISSN: 2155-7772 (ISSN-L)
2155-7780
DOI: 10.4088/pcc.v03n0609
PMC: PMC181193
OpenAlex: W2112953965
Cited by: 661
References: 84
Citations by year: 2026: 19 · 2025: 23 · 2024: 27 · 2023: 32 · 2022: 57 · 2021: 62 · 2020: 50 · 2019: 62 · 2018: 57 · 2017: 41 · 2016: 46 · 2015: 39 · 2014: 28 · 2013: 23 · 2012: 18
FWCI: 0.00
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: The Primary Care Companion For CNS Disorders (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Pfizer
Topics: Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: major depressive disorder, anxiety disorders, comorbidities, primary care, medical utilization, recurrence, psychosocial disability, selective serotonin reuptake inhibitors, antidepressant treatment, chronicity

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The Comorbidity of Major Depression and Anxiety Disorders: Recognition and Management in Primary Care

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