Anxiety symptom relief in depression treatment outcomes.
Depressive and anxiety disorders have a high lifetime prevalence--8% and 15%, respectively. Unipolar depression has a 5% lifetime prevalence, whereas the prevalence rate for all depressive disorders is between 6% to 8% at a minimum. Each disorder has also been found to have a high rate of chronicity and recurrence. It has become increasingly apparent over the past decade that within episodes of depression, anxiety symptoms often exist. Whether this phenomenon indicates two separate but comorbid illnesses or that the presence of anxiety symptoms is part of the course of depression is of particular significance for diagnosis and treatment. The author focuses on the issues of differential diagnosis, including physical and emotional manifestations of the illness. The consequences of comorbid anxiety and depression can be serious, ranging from social and physical disability to suicidal ideation and behavior. Anxiety has been found to be a predictor of suicide in depressed patients, and since anxiety symptoms respond to intervention, they can also serve as an indication of type of treatment. Antidepressants should be used in treating anxiety or panic symptoms when depression is also present. In studies comparing benzodiazepines, monoamine oxidase inhibitors (MAOIs), serotonin selective reuptake inhibitors (SSRIs), and tricyclic antidepressants (TCAs) in the treatment of concurrent anxiety and depression, all have some measure of success depending on the degree of depression and the type of anxiety disorder. SSRIs may have the least amount of side effects, but more long-term studies are needed to determine the long-term efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)
Keller
M B
MB
Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. 02906, USA.
Hanks
D L
DL
D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D003131:Combined Modality Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D003937:Diagnosis, Differential; D006801:Humans; D015995:Prevalence; D011379:Prognosis; D011613:Psychotherapy; D012008:Recurrence; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data; D016896:Treatment Outcome
D000928:Antidepressive Agents