Public health significance of mixed anxiety and depression: beyond current classification

Das‐Munshi, Jayati; Goldberg, David; Bebbington, Paul; Bhugra, Dinesh; Brugha, Traolach; Dewey, Michael; Jenkins, Rachel; Stewart, Robert; Prince, Martin

doi:10.1192/bjp.bp.107.036707

Cited by 180 publications

(150 citation statements)

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“…Here, we will elaborate on the prevalence of MAD. Some researchers found MAD to be a highly prevalent condition (Das-Munshi et al, 2008;Schmidt et al, 2007;Zinbarg et al, 1994), whereas others reported marginal prevalence rates (Means-Christensen et al, 2006;Spijker et al, 2010;Weisberg et al, 2005). For example, we found an annual prevalence rate of .6% in the general population by administering the Composite International Diagnostic Interview and by applying criteria almost similar to the research criteria of DSM-IV, thus excluding those with a current anxiety disorder or depressive disorder as well as excluding those with a history of a major depressive disorder, dysthymic disorder, panic disorder, or generalized anxiety disorder (Spijker et al, 2010).…”

Section: Divergent Results Of Previous Researchmentioning

confidence: 99%

“…Co-occurring subthreshold depression and subthreshold anxiety are associated with impaired functioning (Das-Munshi et al, 2008;Preisig et al, 2001;Roy-Byrne et al, 1994). For example, one fifth of work loss days occurred in those with co-occurring subthreshold depression and subthreshold anxiety (Das-Munshi et al, 2008).…”

mentioning

confidence: 99%

“…epressive and anxiety symptoms are extremely common in the general population and in primary care (Batelaan et al, 2007;Cuijpers et al, 2004;Katon and Roy-Byrne, 1991;Olfson et al, 1996;Ormel et al, 1993;Rucci et al, 2003;Zinbarg et al, 1994), and they frequently co-occur (Das-Munshi et al, 2008;Piccinelli et al, 1999;Preisig et al, 2001;Spijker et al, 2010). Co-occurring subthreshold depression and subthreshold anxiety are associated with impaired functioning (Das-Munshi et al, 2008;Preisig et al, 2001;Roy-Byrne et al, 1994).…”

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confidence: 99%

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Mixed Anxiety Depression Should Not Be Included in DSM-5

Batelaan¹,

Spijker²,

Graaf³

et al. 2012

The Journal of Nervous and Mental Disease

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Subthreshold anxiety and subthreshold depressive symptoms often co-occur in the general population and in primary care. Based on their associated significant distress and impairment, a psychiatric classification seems justified. To enable classification, mixed anxiety depression (MAD) has been proposed as a new diagnostic category in DSM-5. In this report, we discuss arguments against the classification of MAD. More research is needed before reifying a new category we know so little about. Moreover, we argue that in patients with MAD symptoms and a history of an anxiety or depressive disorder, symptoms should be labeled as part of the course trajectories of these disorders, rather than calling it a different diagnostic entity. In patients with incident co-occurring subthreshold anxiety and subthreshold depression, subthreshold categories of both anxiety and depression could be classified to maintain a consistent classification system at both threshold and subthreshold levels.

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Section: Divergent Results Of Previous Researchmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Mixed Anxiety Depression Should Not Be Included in DSM-5

Batelaan¹,

Spijker²,

Graaf³

et al. 2012

The Journal of Nervous and Mental Disease

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“…They are estimated to cause 1 in 5 days lost from work in Britain. 2 There are problems with access to care and with identification of people with CMHDs. In the 2007 household survey of adult psychiatric morbidity only 38% of people with CMHDs had asked their GP for help, and only 24% were receiving treatment (14% medication; 5% counselling; and 5% both).…”

Section: Introductionmentioning

confidence: 99%

Common mental health disorders — identification and pathways to care: NICE clinical guideline

Kendrick

Pilling

2012

Br J Gen Pract

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“…En la presente investigación se encontró que las personas con ansiedad tenían un nivel de AP similar al de las personas sin trastornos, lo cual podría deberse a que el alto AP no necesariamente es indicador de bienestar (Cuadra & En este sentido, se debe mencionar la relevancia clínica y social que tiene el trastorno mixto de ansiedad depresión (Munshi, Goldberg, Bebbington, Bhugra & Brugha, 2008). La comorbilidad de los trastornos ansiosos y depresivos es muy elevada, y ha sido relacionada con variables como la cronicidad y la gravedad de los trastornos, los resultados del tratamiento y las recaídas, la búsqueda de tratamiento, el riesgo de suicidio y el funcionamiento general de los pacientes (Bair, et ál., 2013).…”

Section: Discussionunclassified

Negative and positive affect in Cuban adults with anxiety, depression and without symptoms

Martín-Carbonell

Marín

Díaz³

2015

psdc

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psicología desde el caribe issn 0123-417x (impreso) issn 2011-7485 (on line) Vol. 32, n.° 3, septiembre-diciembre 2015 http://dx.doi.org/10.14482/psdc.32.3.6668 Afectividad negativa y positiva en adultos cubanos con sintomatología ansiosa, depresiva y sin trastornosNegative and positive affect in Cuban adults with anxiety, depression and without symptomsMarta de la Caridad Martín Carbonell* Antonio Riquelme Marín** Raquel Pérez Díaz*** ResumenEl Modelo Bifactorial de Afectividad de Watson y Tellengen se ha postulado para la diferenciación de la ansiedad y la depresión en Europa y Norteamérica, pero no se han reportado estudios en población cubana de edad media. El objetivo de esta investigación fue investigar la Afectividad Positiva (AP) y la Afectividad Negativa (AN) en personas sin psicopatología, con sintomatología predominantemente ansiosa, depresiva o mixta. La muestra fue de 219 personas; 19,2% con sintomatología ansiosa, 17,8% depresiva, 23,7% mixta y el resto sin síntomas. Se utilizó el Inventario de Afecto Positivo y Negativo (PANAS) para estudiar la afectividad y la Escala de Ansiedad y Depresión de Goldberg (EADG) para diferenciar los subgrupos diagnósticos. Se utilizó el ANOVA de un factor con el Método de la Diferencia Significativa Honesta de Tukey para establecer las diferencias. Se encontró que la AP era menor en los depresivos tal y como predice el Modelo, pero no se cumplió la predicción de que la AP diferenciaría a los ansiosos de las personas sin síntomas, y se encontró que en el grupo con sintomatología mixta había mayor AN y menor AP que en los otros subgrupos patológi-cos, lo cual alerta sobre la necesidad de evaluar los modelos desarrollados en otras culturas. AbstractTwo-Factor Model of Emotion of Watson and Tellengen has been investigated for the differentiation of anxiety and depression in Europe and North America, but no studies have been reported on middle-aged Cuban population. The objective of this research was to investigate the negative (NA) and positive affectivity (PA) in individuals without psychopathology, predominantly anxious, depressive or mixed symptoms. The sample was 219 subjects; 19.2% with symptoms of anxiety, 17.8% has depression, 23.7% mixed anxiety and depression symptoms, and the rest without symptoms. Positive and negative affect schedule (PANAS) was used to study emotion; and Anxiety and Depression Scale Goldberg (GADS) to differentiate diagnostic subgroups. The one-way ANOVA was used with the method of Tukey Honest Significant Difference. We found that AP was lower in depressive as predicted by the model, but the prediction that the AP would differentiate anxious people without symptoms was fulfilled, which highlights the need to evaluate the models developed in other cultures.

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Public health significance of mixed anxiety and depression: beyond current classification

Abstract: The data support the pathological significance of MADD in its negative impact upon population health. Dimensional approaches to classification may provide a more parsimonious description of anxiety and depressive disorders compared with categorical approaches.

Cited by 180 publications

References 20 publications

Mixed Anxiety Depression Should Not Be Included in DSM-5

Mixed Anxiety Depression Should Not Be Included in DSM-5

Common mental health disorders — identification and pathways to care: NICE clinical guideline

Negative and positive affect in Cuban adults with anxiety, depression and without symptoms

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