Who is MADD? Mixed anxiety depressive disorder in the general population

Background: Diagnostic criteria for (subthreshold) mixed anxiety depression (MADD) were proposed in DSM-IV. Yet the usefulness of this classification is questioned. We therefore assessed the prevalence of MADD, and investigated whether MADD adds to separate classifications of pure subthreshold depression and anxiety. Method: Data of the Netherlands Mental Health and Incidence Study were used. Results: The 12-month prevalence of MADD was 0.6%. Between the three subthreshold categories few differences were found with regard to socio-demographic variables, care utilisation and functioning. Course in MADD seems more favourable and MADD is not a stable diagnosis over time. Limitations: The MADD criteria used in the present study differed slightly from the proposed criteria in DSM-IV and sample sizes were small. Conclusions: Given these results, MADD is not a relevant diagnosis in terms of prevalence and consequences when classified according to the currently proposed criteria. © 2009 Elsevier B.V. All rights reserved.