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Symptom Similarities and Differences in Anxiety and Depressive Disorders

Year 2010, Volume: 2 Issue: 1, 1 - 14, 01.03.2010

Abstract

The question if there is a valid distinction between depression and anxiety disorders remains controversial. These two disorders have various overlaps in the symptomatology and sometimes it is difficult to make a clear diagnosis. The difficulty in making a definite diagnosis destined researchers to determine the differences and the similarities between anxiety and depression. The negative affect which has multiple dimensions such as low self-esteem, negative mood and negative cognitions is seen as the common factor in both disorders. The positive affect which has been defined as the harmony and satisfaction with others and milieu, is regarded as the discriminating factor for the diagnosis of depression. Further research has characterized somatic arousal as the third dimension, a candidate to be the discriminating factor for anxiety disorders. Although phenotypic models appear to find a solution for this problem the facts that negative affect dimension is more loaded compared to the other two dimensions and predominance of negative affect on several symptom patterns prevent researchers to reach a conclusive results regarding the differences between these two disorders. In this review article, symptom similarities and differences of anxiety and depressive disorders are discussed within the frame of phenotypic models and some alternative ideas are provided for possible changes in upcoming versions of classification systems.

References

  • Maser JD, Cloninger CR. (Ed). Comorbidity of Mood and Anxiety Disorders. Washington, DC: American Psychiatric Press, Inc. 2005; 505-509.
  • Amerikan Psikiyatri Birliği. Psikiyatride Hastalıkların Tanımlanması ve Sınıflandırılması Elkitabı, Yeniden Gözden Geçirilmiş 4. Baskı (DSM-IV-TR), (E.Köroğlu, Çev.) Ankara, Hekimler Yayın Birliği. 2001.
  • Aydın H, Tamam L. Anksiyöz depresyon: Bir depresyon alt grubu mu? Anadolu Psiki- yatri Dergisi 2005; 6:177-187.
  • Zuckerman M. Vulnerability to Psychopathology. USA, 1999.
  • Clark LA, Watson D. Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. J Abnorm Psychol 1991; 100:316-336.
  • Mineka S, Watson D, Clark LA. Comorbidity of anxiety and unipolar mood disorders. Ann Rev Psychol 1998; 49:377-412.
  • Hecht H, Zerssen D, Wittchen HU. Anxiety and depresion in a community sample: The influence of comorbidity on social functioning. J Affect Disord 1990; 18:137-144.
  • Sartorius N, Uestuen TB, Lecrubier Y, Wittchen HU. Depression comorbid with anxiety: Results from the WHO study on ``Psychological disorders in primary health care''. Br J Psychiatry 1996; 168:38-43.
  • Rivas-Vazquez RA, Saffa-Biller D, Ruiz I, Blais MA, Rivas-Vazquez A.. Current issues an anxiety and depression: Comorbid, mixed, and subthehold disorders. Prof Psychol Res Pr 2004; 35:74-83.
  • Krueger RF. The structure of common mental disorders. Arch Gen Psychiatry 1999; 56: 921–926.
  • Goldberg D. Towards DSM-V: the relationship between generalized anxiety disorder and major depressive epizod. Psychol Med 2008; 38:1671-1675.
  • Küey L, Özmen E, Demet MM, Aydemir Ö, Gülseren Ş, Kültür S. Depresif bozukluklar ve anksiyete bozukluklarının karşılaştırmalı fenomenolojisi. Türk Psikiyatri Derg 1996; 7:169-175.
  • Küey L, Aydemir Ö, Gülseren Ş, Kültür S. Majör depresyon, anksiyete bozukluğu ve eştanılı durumlarda ayrışan ve örtüşen özellikler-1. Türk Psikiyatri Derg 1997; 7:257- 265.
  • Clark LA, Watson D, Mineka S. Temperament, personality, and the mood and anxiety disorders. J Abnorm Psychol 1994; 103:103–116.
  • Kendall PC, Watson D. Anxiety and depression: Distinctive and overlapping features. Academic Press San Diego, CA 1989.
  • Watson D, Clark LA, Carey G. Positive and negative affectivity and their relation to anxiety and depressive disorders. J Abnorm Psychol 1988; 97:346-353.
  • Watson D, Clark LA. Negative affectivity: The disposition to experience aversive emotional states. Psychol Bull 1984;96:465-490.
  • Williams J, Peeters F, Zautra A. Differential affect structure in depressive and anxiety disorders. Anxiety Stress Coping 2004; 17:321-330.
  • Bouman TK, Luteijn F. Relations between the Pleasant Events Schedule, depression, and other aspects of psychopathology. J Abnorm Psychol 1986; 95:373-377.
  • Brown TA, Chorpita BF, Barlow DH. Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, affect, and autonomic arousal. J Abnorm Psychol 1998; 107:179-192. positive
  • Barlow DH. The nature of anxiety: anxiety, depression, and emotional disorders. In Chronic Anxiety: Generalized Anxiety Disorder and Mixed Anxiety-Depression, (Eds. RM Rapee, DH Barlow). New York. Guilford. 1991; pp. 1-28.
  • Zautra AJ, Berkhof J, Nicolson NA. Changes in affect interrelations as a function of stressful event. Cogn Emot 2002; 16:309-318.
  • Barlow DH, Chorpita BF, Turovsky J. Fear, panic, anxiety and disorders of emotion. In Nebraska Symposium on Motivation: Vol. 43, (Ed. DA Hope) Lincoln, Univ. Neb. Press. 1996; pp. 251–328.
  • Beurs E, Hollander-Gijsman ME, Helmich S, Zitman FG. The tripartite model for assessing symptoms of anxiety and depression: Psychometrics of the Dutch version of the mood and anxiety symptoms questionnaire. Behav Res Ther 2007; 45:1609- 1617.
  • Watson D, Clark LA, Weber K, Assenheimer JS, Strauss ME, McCormick RA. Testing a tripartite model: II. Exploring the symptom structure of anxiety and depression in student, adult, and patient samples. J Abnorm Psychol 1995; 104:15-25.
  • Watson D, Weber K, Assenheimer JS, Clark LA, Strauss ME, McCormick RA. Testing a tripartite model. I. Evaluating the convergent and discriminant validity of anxiety and depression symptom scales. J Abnorm Psychol 1995; 104:3-14.
  • Joiner TE, Catanzaro SJ, Laurent J. Tripartite structure of positive and negative affect, depression, and anxiety in child and adolescent psychiatric inpatients. J Abnorm Psychol 1996; 105:401-409.

Anksiyete ve Depresif Bozukluklarda Örtüşen ve Ayrışan Belirtiler

Year 2010, Volume: 2 Issue: 1, 1 - 14, 01.03.2010

Abstract

Anksiyete bozuklukları ve depresyon arasında geçerli bir ayrımın olup olmadığı tartışmalı bir konudur. Her iki bozukluğun belirtilerinde önemli örtüşmeler vardır ve bu durum kesin tanıya karar vermeyi zorlaştırabilir. Bu sorunu gören araştırmacılar, anksiyete ve depresyonun örtüşen ve farklılaşan belirtileri belirlemeye yönelmişlerdir. Bu noktada yapılan araştırmalar, düşük özdeğerlilik, olumsuz duygudurum ve bilişlerin varlığı gibi çeşitli boyutları olan negatif duygudurumun bu iki bozukluğun ortak noktası olduğunu göstermektedir. Kişinin çevre ile uyum ve memnuniyet düzeyini yansıtan pozitif duygudurumun yetersizliği ise, depresyon için ayırt edici nokta olarak tanımlanmaktadır. Daha sonraki çalışmalar ise, anksiyete bozuklukları için ayırt edici faktörün belirlenmesinin gerekliliğine odaklanarak, somatik/otonomik uyarılma faktörünü üçüncü boyut olarak tanımlamışlardır. Fenotipik modeller, teorik olarak sorunu çözmüş görünse de, negatif duygudurum boyutunun diğer iki boyuta göre oldukça yüklü olması, bazı belirti görünümlerinin sadece negatif duygudurum faktörünü içermeleri sebebiyle belirti benzerliği ve farklılığı üzerine yapılan çalışmalar halen bir çok soru işareti taşımaktadır. Bu gözden geçirmede anksiyete ve depresif bozuklukların belirtilerindeki benzerlikler ve farklılıklar fenotipik modeller çerçevesinde ele alınmış, bu değerlendirmeden yola çıkılarak, gelinen nokta ve mevcut sınıflama sistemi için olası değişim önerileri sunulmuştur.

References

  • Maser JD, Cloninger CR. (Ed). Comorbidity of Mood and Anxiety Disorders. Washington, DC: American Psychiatric Press, Inc. 2005; 505-509.
  • Amerikan Psikiyatri Birliği. Psikiyatride Hastalıkların Tanımlanması ve Sınıflandırılması Elkitabı, Yeniden Gözden Geçirilmiş 4. Baskı (DSM-IV-TR), (E.Köroğlu, Çev.) Ankara, Hekimler Yayın Birliği. 2001.
  • Aydın H, Tamam L. Anksiyöz depresyon: Bir depresyon alt grubu mu? Anadolu Psiki- yatri Dergisi 2005; 6:177-187.
  • Zuckerman M. Vulnerability to Psychopathology. USA, 1999.
  • Clark LA, Watson D. Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. J Abnorm Psychol 1991; 100:316-336.
  • Mineka S, Watson D, Clark LA. Comorbidity of anxiety and unipolar mood disorders. Ann Rev Psychol 1998; 49:377-412.
  • Hecht H, Zerssen D, Wittchen HU. Anxiety and depresion in a community sample: The influence of comorbidity on social functioning. J Affect Disord 1990; 18:137-144.
  • Sartorius N, Uestuen TB, Lecrubier Y, Wittchen HU. Depression comorbid with anxiety: Results from the WHO study on ``Psychological disorders in primary health care''. Br J Psychiatry 1996; 168:38-43.
  • Rivas-Vazquez RA, Saffa-Biller D, Ruiz I, Blais MA, Rivas-Vazquez A.. Current issues an anxiety and depression: Comorbid, mixed, and subthehold disorders. Prof Psychol Res Pr 2004; 35:74-83.
  • Krueger RF. The structure of common mental disorders. Arch Gen Psychiatry 1999; 56: 921–926.
  • Goldberg D. Towards DSM-V: the relationship between generalized anxiety disorder and major depressive epizod. Psychol Med 2008; 38:1671-1675.
  • Küey L, Özmen E, Demet MM, Aydemir Ö, Gülseren Ş, Kültür S. Depresif bozukluklar ve anksiyete bozukluklarının karşılaştırmalı fenomenolojisi. Türk Psikiyatri Derg 1996; 7:169-175.
  • Küey L, Aydemir Ö, Gülseren Ş, Kültür S. Majör depresyon, anksiyete bozukluğu ve eştanılı durumlarda ayrışan ve örtüşen özellikler-1. Türk Psikiyatri Derg 1997; 7:257- 265.
  • Clark LA, Watson D, Mineka S. Temperament, personality, and the mood and anxiety disorders. J Abnorm Psychol 1994; 103:103–116.
  • Kendall PC, Watson D. Anxiety and depression: Distinctive and overlapping features. Academic Press San Diego, CA 1989.
  • Watson D, Clark LA, Carey G. Positive and negative affectivity and their relation to anxiety and depressive disorders. J Abnorm Psychol 1988; 97:346-353.
  • Watson D, Clark LA. Negative affectivity: The disposition to experience aversive emotional states. Psychol Bull 1984;96:465-490.
  • Williams J, Peeters F, Zautra A. Differential affect structure in depressive and anxiety disorders. Anxiety Stress Coping 2004; 17:321-330.
  • Bouman TK, Luteijn F. Relations between the Pleasant Events Schedule, depression, and other aspects of psychopathology. J Abnorm Psychol 1986; 95:373-377.
  • Brown TA, Chorpita BF, Barlow DH. Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, affect, and autonomic arousal. J Abnorm Psychol 1998; 107:179-192. positive
  • Barlow DH. The nature of anxiety: anxiety, depression, and emotional disorders. In Chronic Anxiety: Generalized Anxiety Disorder and Mixed Anxiety-Depression, (Eds. RM Rapee, DH Barlow). New York. Guilford. 1991; pp. 1-28.
  • Zautra AJ, Berkhof J, Nicolson NA. Changes in affect interrelations as a function of stressful event. Cogn Emot 2002; 16:309-318.
  • Barlow DH, Chorpita BF, Turovsky J. Fear, panic, anxiety and disorders of emotion. In Nebraska Symposium on Motivation: Vol. 43, (Ed. DA Hope) Lincoln, Univ. Neb. Press. 1996; pp. 251–328.
  • Beurs E, Hollander-Gijsman ME, Helmich S, Zitman FG. The tripartite model for assessing symptoms of anxiety and depression: Psychometrics of the Dutch version of the mood and anxiety symptoms questionnaire. Behav Res Ther 2007; 45:1609- 1617.
  • Watson D, Clark LA, Weber K, Assenheimer JS, Strauss ME, McCormick RA. Testing a tripartite model: II. Exploring the symptom structure of anxiety and depression in student, adult, and patient samples. J Abnorm Psychol 1995; 104:15-25.
  • Watson D, Weber K, Assenheimer JS, Clark LA, Strauss ME, McCormick RA. Testing a tripartite model. I. Evaluating the convergent and discriminant validity of anxiety and depression symptom scales. J Abnorm Psychol 1995; 104:3-14.
  • Joiner TE, Catanzaro SJ, Laurent J. Tripartite structure of positive and negative affect, depression, and anxiety in child and adolescent psychiatric inpatients. J Abnorm Psychol 1996; 105:401-409.
There are 27 citations in total.

Details

Primary Language Turkish
Journal Section Review
Authors

Dilek Şirvanlı Özen This is me

Elif Temizsu This is me

Publication Date March 1, 2010
Published in Issue Year 2010 Volume: 2 Issue: 1

Cite

AMA Özen DŞ, Temizsu E. Anksiyete ve Depresif Bozukluklarda Örtüşen ve Ayrışan Belirtiler. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. March 2010;2(1):1-14.

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