Mixed Anxiety Depression Should Not Be Included in DSM-5

N.M. Batelaan, J. Spijker, R. de Graaf, P. Cuijpers

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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. Copyright © 2012 by Lippincott Williams & Wilkins.
Original languageEnglish
Pages (from-to)495-498
Number of pages4
JournalJournal of Nervous and Mental Disease
Volume200
Issue number6
DOIs
Publication statusPublished - 2012

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