THE COMORBIDITY OF ANXIETY AND DEPRESSION

Objective: This study explored the effect of comorbid anxiety disorder s in patients admitted to an inpatient specialist Mood Disorders Unit for the treatment of a primary major depressive episode. Method: Subje cts were assessed on admission and discharge. DSM-III-R diagnoses for major depression and anxiety disorders were established using CIDI-Aut o; comorbid anxiety disorders were coexistent in time with the major d epression, with both conditions meeting diagnostic criteria at the tim e of assessment. Severity of illness was assessed using the Hamilton D epression/Melancholia Scale, the revised Hamilton Anxiety Scale and th e revised Beck Depression Inventory. Results: For the analysis, the st udy cohort was divided into three groups: depression alone (n = 33), o ne comorbid anxiety disorder (n = 15), and two or more comorbid anxiet y disorders (n = 24). No particular anxiety disorder predominated. Int erestingly, the presence or absence of comorbid anxiety with severe ma jor depression made no significant difference to treatment choice or o utcome results. Specifically, there was no significant difference betw een the three groups in the utilisation of electroconvulsive therapy a nd pharmacotherapy (including antidepressants, benzodiazepines and neu roleptics); all subjects improved significantly on both depression and anxiety ratings, and length of inpatient stay did not vary significan tly between the three groups. Conclusions: The existence of comorbid a nxiety disorders in those patients who presented for treatment of a pr imary major depressive episode did not significantly effect choice of treatment or treatment outcome, suggesting that there is a close inter relationship between the two conditions.