Mixed anxiety depression should not be included in DSM-5 |
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Authors: | Batelaan Neeltje M Spijker Jan de Graaf Ron Cuijpers Pim |
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Institution: | Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands. n.batelaan@ggzingeest.nl |
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Abstract: | Subthreshold anxiety and subthreshold depressive symptoms often co-occur in the general population and in primary care. Based on their associated significant distress and impairment, a psychiatric classification seems justified. To enable classification, mixed anxiety depression (MAD) has been proposed as a new diagnostic category in DSM-5. In this report, we discuss arguments against the classification of MAD. More research is needed before reifying a new category we know so little about. Moreover, we argue that in patients with MAD symptoms and a history of an anxiety or depressive disorder, symptoms should be labeled as part of the course trajectories of these disorders, rather than calling it a different diagnostic entity. In patients with incident co-occurring subthreshold anxiety and subthreshold depression, subthreshold categories of both anxiety and depression could be classified to maintain a consistent classification system at both threshold and subthreshold levels. |
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