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JAMA Network Insights
April 15, 2020

Advice for Clinicians on How to Treat Comorbid Anxiety and Depression

Author Affiliations
  • 1Pro Pergratersona Mental Health Care, Depression Expertise Center, Nijmegen, the Netherlands
  • 2Radboud University Nijmegen, the Netherlands
  • 3Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
  • 4GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
JAMA Psychiatry. 2020;77(6):645-646. doi:10.1001/jamapsychiatry.2020.0601

Depressive and anxiety disorders frequently co-occur. It is widely known that the outcome of comorbid anxiety and depressive disorder together is more negative than each single counterpart. Clinically, comorbidity is associated with greater severity of symptoms, with an increased risk of suicide, a more reduced quality of life, and a more limited level of functioning.1 Although it can be questioned whether it is best to view depression and anxiety as a single condition or distinct conditions, current clinical practice is to diagnose both disorders separately and refer to comorbidity. However, a clear-cut optimal treatment strategy for comorbid anxiety and depression is lacking. Should we treat the disorders sequentially (treating one and subsequently the other) or parallel (treating both disorders simultaneously)? Should we start a single treatment focusing on both disorders (integrated treatment) or a transdiagnostic treatment focusing on underlying mechanisms present in both anxiety and depressive disorders?2

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