MIXED ANXIETY-DEPRESSION IN A PRIMARY-CARE CLINIC

To determine the prevalence and clinical significance of a mixed anxie ty-depressive (MAD) syndrome in primary care, a two-stage sampling des ign was applied to 796 consecutive clinic attendees without known psyc hiatric illness. Among 78 systematically interviewed subjects, 10.3% ( n = 8) had a depressive disorder alone, 12.8% (n = 10) had an anxiety disorder alone, 19.2% (n = 15) had a comorbid anxiety and depressive d isorder and 12.8% (n = 10) had a combination of subsyndromal anxiety a nd depressive features that fulfilled either ICD-10 or our own operati onal criteria for MAD. Patients with MAD rated their disability as bei ng comparable to that of patients with anxiety or depressive disorders . These findings lend support to the notion that there is a sizeable s ubgroup of patients in primary care who appear to be suffering from a psychiatric syndrome with an admixture of subsyndromal depressive and anxiety features. Questions about the temporal stability of MAD and pr eferred approaches to treatment have yet to be answered.