When Anxiety and Depression Coexist: The Role of Differential Diagnosis Using Clinimetric Criteria

F. Cosci*, G.A. Fava

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Web of Science)

Abstract

Depressive and anxiety disorders are frequently associated. Depression may be a complication of anxiety and anxiety can complicate depression. The nature of their relationship has been a source of controversy. Reviews generally base their conclusions on randomized controlled trials and meta-analyses that refer to the average patient and often clash with the variety of clinical presentations that may occur when anxiety and depression coexist. The aim of this review was to examine the literature according to profiling of subgroups of patients based on clinimetric criteria, in line with the recently developed concept of medicine-based evidence. We critically reviewed the literature pertaining to the specific presentations of anxiety and depression, outlining the advantages and disadvantages of each treatment approach. The following prototypic cases were presented: depression secondary to an active anxiety disorder, depression in patients with anxiety disorders under treatment, anxious depression, anxiety as a residual component of depression, and demoralization secondary to anxiety disorder. We argue that the selection of treatment when anxiety and depression coexist should take into account the modalities of presentation and be filtered by clinical judgment. Very different indications may ensue when the literature is examined according to this perspective.
Original languageEnglish
Pages (from-to)308-317
Number of pages10
JournalPsychotherapy and Psychosomatics
Volume90
Issue number5
DOIs
Publication statusPublished - 1 Aug 2021

Keywords

  • Depression
  • Clinimetrics
  • Anxiety
  • Psychotropic drugs
  • Cognitive behavioral therapy
  • Medicine-based evidence
  • Well-being therapy
  • WELL-BEING THERAPY
  • PANIC DISORDER
  • NONANXIOUS DEPRESSION
  • MENTAL-DISORDERS
  • CO-MORBIDITY
  • COMORBIDITY
  • AGORAPHOBIA
  • SYMPTOMS
  • DEMORALIZATION
  • MAINTENANCE

Cite this