Psychiatr. praxi. 2022;23(3):153-159 | DOI: 10.36290/psy.2022.033

Mixed anxiety and depressive disorder: a review of the literature

MUDr. Eliška Bartečková, Ph.D., MUDr. Jana Hořínková, Ph.D., MUDr. Pavel Křenek

Psychiatrická klinika Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno

Mixed anxiety and depressive disorder is a diagnostic category in the 10^th and 11^th editions of the International Classification of Diseases (ICD). It can be made when a patient shows co-occurring anxiety and depressive symptoms causing significant distress but not expressed in such severity that another anxiety or affective disorder can be diagnosed. Sometimes the existence of this disorder is questioned because of the low severity of symptoms, the difficulty of delineating it from similar conditions and the low diagnostic reliability. For example, it does not appear in the most recent fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. However, in the context of the ICD, it is one of the most common psychiatric diagnoses, particularly in primary care. In the differential diagnosis, it is necessary first to exclude a possible physical cause of the disorder and then to rule out other situations where depressive and anxiety symptomatology may occur together, such as comorbid depressive and anxiety disorders. In pharmacological therapy, antidepressants from the group of selective serotonin reuptake inhibitors are primarily used. If unsuccessful, other agents with simultaneous efficacy on depressive and anxiety symptoms may be used. As adjuvant therapy, anxiolytics may be given for a limited time. Psychotherapy, particularly cognitive behavioural psychotherapy, is an essential therapeutic modality.

Keywords: mixed anxiety and depressive disorder, mixed depressive and anxiety disorder, subsyndromal anxiety, subsyndromal depression.

Accepted: October 11, 2022; Published: October 25, 2022  Show citation