Trying to describe mixed anxiety and depression: Have we lost our way?

Mulder, Roger; Bassett, Darryl; Morris, Grace; Hamilton, Amber; Baune, Bernhard T.; Boyce, Philip; Hopwood, Malcolm; Parker, Gordon; Porter, Richard; Singh, Ajeet; Das, Pritha; Outhred, Tim; Malhi, Gin S

doi:10.1002/da.22961

Cited by 8 publications

(5 citation statements)

References 9 publications

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“…Several variables affected changes in anxiety but not depression, or vice versa, which could provide insight into the differences between depression and anxiety. Historically, scientists have vacillated between consideration of depression and anxiety as the same disorder, different disorders located along the same affective spectrum, and entirely different disorders with unique symptomatology [32,33]. Depression and anxiety are very often comorbid in patients with psychiatric disorders [32], and until recently, self-report measures have rarely been able to distinguish between their symptoms [34].…”

Section: Discussionmentioning

confidence: 99%

“…Depression and anxiety are very often comorbid in patients with psychiatric disorders [32], and until recently, self-report measures have rarely been able to distinguish between their symptoms [34]. But pharmacological separation exists in their treatments (antidepressants and anxiolytics, respectively) [33], and both overlapping and distinct neurobiological profiles have been found to be associated with depression and anxiety in neuroimaging studies [35]. Traditionally, depression has been associated with hopelessness and helplessness [35], whereas anxiety is often characterized by uncertainty and fear of the unknown [36,37].…”

Section: Discussionmentioning

confidence: 99%

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Emotional adaptation during a crisis: decline in anxiety and depression after the initial weeks of COVID-19 in the United States

et al. 2021

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Crises such as the COVID-19 pandemic are known to exacerbate depression and anxiety, though their temporal trajectories remain under-investigated. The present study aims to investigate fluctuations in depression and anxiety using the COVID-19 pandemic as a model crisis. A total of 1512 adults living in the United States enrolled in this online study beginning April 2, 2020 and were assessed weekly for 10 weeks (until June 4, 2020). We measured depression and anxiety using the Zung Self-Rating Depression scale and State-Trait Anxiety Inventory (state subscale), respectively, along with demographic and COVID-related surveys. Linear mixed-effects models were used to examine factors contributing to longitudinal changes in depression and anxiety. We found that depression and anxiety levels were high in early April, but declined over time. Being female, younger age, lower-income, and previous psychiatric diagnosis correlated with higher overall levels of anxiety and depression; being married additionally correlated with lower overall levels of depression, but not anxiety. Importantly, worsening of COVID-related economic impact and increase in projected pandemic duration exacerbated both depression and anxiety over time. Finally, increasing levels of informedness correlated with decreasing levels of depression, while increased COVID-19 severity (i.e., 7-day change in cases) and social media use were positively associated with anxiety over time. These findings not only provide evidence for overall emotional adaptation during the initial weeks of the pandemic, but also provide insight into overlapping, yet distinct, factors contributing to depression and anxiety throughout the first wave of the pandemic.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Emotional adaptation during a crisis: decline in anxiety and depression after the initial weeks of COVID-19 in the United States

et al. 2021

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“…ICD-11 has retained this diagnosis but changed its name to mixed depressive and anxiety disorder and moved it to the mood disorders section. DSM-5 has included a new ‘with anxious distress’ specifier in the mood disorders section (Mulder et al, 2019).…”

Section: Management Of Major Depressive Disordermentioning

confidence: 99%

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Malhi

Bell

Bassett³

et al. 2020

Aust N Z J Psychiatry

Self Cite

348

365

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Objectives: To provide advice and guidance regarding the management of mood disorders, derived from scientific evidence and supplemented by expert clinical consensus to formulate s that maximise clinical utility. Methods: Articles and information sourced from search engines including PubMed, EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (e.g. books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Relevant information was appraised and discussed in detail by members of the mood disorders committee, with a view to formulating and developing consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous consultation and external review involving: expert and clinical advisors, key stakeholders, professional bodies and specialist groups with interest in mood disorders. Results: The Royal Australian and New Zealand College of Psychiatrists mood disorders clinical practice guidelines 2020 (MDcpg2020) provide up-to-date guidance regarding the management of mood disorders that is informed by evidence and clinical experience. The guideline is intended for clinical use by psychiatrists, psychologists, primary care physicians and others with an interest in mental health care. Conclusion: The MDcpg2020 builds on the previous 2015 guidelines and maintains its joint focus on both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. Mood disorders committee: Gin S Malhi (Chair), Erica Bell, Darryl Bassett, Philip Boyce, Richard Bryant, Philip Hazell, Malcolm Hopwood, Bill Lyndon, Roger Mulder, Richard Porter, Ajeet B Singh and Greg Murray.

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“…This can potentially be explained by the fundamental differences between depression and anxiety. Historically, scientists have vacillated between consideration of depression and anxiety as the same disorder, different disorders on the same affective spectrum, and entirely different disorders with unique symptomatology [25,26]. Depression and anxiety are very often comorbid in patients with psychiatric disorders [25], and until recently, self-report measures rarely distinguished adequately between their symptoms [27].…”

Section: Resultsmentioning

confidence: 99%

“…Depression and anxiety are very often comorbid in patients with psychiatric disorders [25], and until recently, self-report measures rarely distinguished adequately between their symptoms [27]. But pharmacological separation exists between their treatments (antidepressants and anxiolytics, respectively) [26], and both overlapping and distinct neurobiological profiles have been found to be associated with depression and anxiety in neuroimaging studies [28]. Traditionally, depression has been associated with sadness about the past , whereas anxiety has been described as maladaptive anticipation of the future [27].…”

Section: Discussionmentioning

confidence: 99%

Emotional Adaptation During A Crisis: Decline in Anxiety and Depression After the Initial Weeks of COVID-19 in the United States

Shuster

O’Brien

Luo

et al. 2020

Preprint

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ObjectiveCrises such as the COVID-19 pandemic are known to exacerbate depression and anxiety, though their temporal trajectories remain unclear. The present study aims to investigate fluctuations in depression and anxiety using COVID-19 as a model crisis.Methods1,512 adults living in the U.S. enrolled in this online study on April 2nd, 2020 and were assessed weekly for 10 weeks (until June 4th, 2020; final n=537). Depression and anxiety were measured using the Zung Self-Rating Depression scale and State-Trait Anxiety Inventory (state subscale), respectively, along with demographic and COVID-related questions. Mixed-effects linear regression models were used to examine factors contributing to longitudinal changes in depression and anxiety.ResultsDepression and anxiety levels were high in early April, but declined over time (F(9,4824)=17.53, p<.001 and F(9,4824)=23.35, p<.001, respectively). In addition to demographic factors such as sex, age, income, and psychiatric diagnoses, we identified some overlapping and some distinct dynamic factors contributing to changes in depression and anxiety: worsening of weekly individual economic impact of COVID-19 increased both depression and anxiety, while increased seven-day change in COVID-19 cases, social media use, and projected pandemic duration were positively associated with anxiety, but not depression.ConclusionsAlongside evidence for overall emotional adaptation, these findings highlight overlapping (economic), yet distinct (change in COVID-19 cases, social media use, and projected COVID-19 duration) factors contributing to fluctuations in depression and anxiety throughout the first wave of COVID-19. These results provide insight into socioeconomic policies and behavioral changes that can increase emotional adaptation in times of crisis.

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Trying to describe mixed anxiety and depression: Have we lost our way?

Cited by 8 publications

References 9 publications

Emotional adaptation during a crisis: decline in anxiety and depression after the initial weeks of COVID-19 in the United States

Emotional adaptation during a crisis: decline in anxiety and depression after the initial weeks of COVID-19 in the United States

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Emotional Adaptation During A Crisis: Decline in Anxiety and Depression After the Initial Weeks of COVID-19 in the United States

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