Mixed anxiety and depression: should it be included in DSM-IV?
DSM-IV is provisionally including a category of mixed anxiety and depression for several reasons. First, it will be included in ICD-10, and therefore used worldwide. The ICD-10 category and the mixed anxiety and depression category now being included in the appendix of DSM-IV are subsyndromal in that they include patients with both anxious and depressive symptoms that fail to meet criteria for an established anxiety or depression diagnosis. Primary-care physicians regularly report a high incidence of patients whose symptoms fit this subsyndromal definition of mixed anxiety and depression. Such patients are not easily classifiable using DSM-III or DSM-III-R criteria, yet they often manifest sufficient distress and/or disability to require treatment. Those who oppose establishing the diagnosis of mixed anxiety and depression make the following points: (1) patients considered eligible for this diagnosis will actually meet criteria for a current DSM disorder; (2) mixed anxiety and depression will become a "wastebasket" category for a heterogeneous group of patients; (3) if any new subsyndromal diagnosis is needed, minor depression should suffice; and (4) mixed anxiety and depression will overlap extensively with adjustment reaction.
Department of Clinical Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY.
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Liebowitz
D000275:Adjustment Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D001008:Anxiety Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D011569:Psychiatric Status Rating Scales; D009626:Terminology as Topic