Coexisting Depression and Anxiety: Classification and Treatment

Abstract

A b s t r a c t Despite of the fact, that comorbidity of depression and anxiety is a frequent condition in clinical practice, current psychiatric classification systems (according to WHO-ICD 10 and according to APA-DSM IV-TR) are not taking this reality into account sufficiently. The concept of anxious depression is very important for clinical practice. Recommended guidelines and algorithms of treatment based on evidence based medicine (EBM), established mainly on randomized controlled trials are designed separately for depression and separately for anxious disorders. This presents very often a significant complication in clinical practice. The aim of this article was to bring the concept of anxious depression to closer attention with highlighting of possible therapeutic approaches.

Predicting depression outcome in mental health treatment: A recursive partitioning analysis

“…There is some indication that antidepressant medications that are serotonin-norepinephrine reuptake inhibitors (SNRIs) may have greater clinical utility in medical treatment of anxious depression than drugs that are reuptake inhibitors of serotonin only (Silverstone & Von Studnitz, 2003), and a handful of articles, primarily case studies and reviews, have investigated specific modifications of CBT for psychotherapy of anxious depression (e.g., Joiner, Voelz, & Rudd, 2001;Kush, 2004;Moras, Telfer, & Barlow, 1993). However, nearly all treatment guidelines for anxious depression extrapolate from research on each condition in isolation, even despite evidence that treatment is less effective for the combined concerns (Kulhan, Ondrejka, Ordaz, Snircova, & Nosalova, 2012). Our findings join the existing literature to emphasize that intervention development research for the specific combination of anxiety and depression and specific research-based guidelines for treating the comorbid conditions are badly needed.…”