[Comorbid anxiety and depression: Diagnostic issues and treatment management].
Epidemiological data show that besides the high prevalence of anxiety and depressive disorders  in the general population, comorbidity between the two is a very frequent phenomenon. There  is a variety in the clinical presentation of comorbidity. Comorbidity may be present as the full  clinical picture of the two syndromes or as limited symptoms from both two syndromes. Anxiety  disorders usually are the first manifestation. The impact of comorbidity is reflected in the severity  of the disorder, the chronicity and persistency of its course, the more functional impairment and  the worse quality of patient's life. There is interplay between several genetic, neurobiological  and environmental risk factors leading to comorbidity. Disturbances of the serotoninergic and  noradrenergic systems, as well as of the hypothalamic-pituitary-adrenal axis have been implicated  in the pathophysiology of comorbidity. Treatment with novel antidepressants and anxiolytics, as  well as psychotherapeutic approaches has proven to be effective for the management of comorbid  anxiety and depression.
1st Psychiatric Department, University of Athens, Eginition Hospital Athens, Greece.
G
G
Balta
T
T
Paparrigopoulos