Stahl S M
Department of Psychiatry, University of California, San Diego.
J Clin Psychiatry. 1993 Jan;54 Suppl:33-8.
Although depressive and anxious symptoms frequently coexist, clinical studies have tended to separate anxiety disorders from depression. A number of developments are now reversing this trend. One of these developments is the reworking of the concept of generalized anxiety disorder (GAD) from that of a residual category (anxiety after all other anxiety disorders are removed) to a generalized anxiety syndrome that includes symptoms of mild depression that are less severe than the symptoms of anxiety. GAD is thereby expanded to a broader concept, namely mixed anxiety/depression (MAD). A second major development, however, posits a different definition of MAD: a stable core of subsyndromal symptoms that do not reach the threshold for the diagnosis of GAD or depression, but which, under stress, will decompensate to an overt anxiety disorder or depression.
尽管抑郁症状和焦虑症状常常同时存在，但临床研究往往将焦虑症与抑郁症区分开来。现在有一些新进展正在扭转这一趋势。其中一个进展是对广泛性焦虑症（GAD）概念的重新界定，从残余类别（去除所有其他焦虑症后的焦虑）转变为一种广泛性焦虑综合征，该综合征包括比焦虑症状程度较轻的轻度抑郁症状。GAD从而扩展为一个更宽泛的概念，即混合性焦虑/抑郁（MAD）。然而，第二个主要进展对MAD提出了不同的定义：一组稳定的亚综合征症状核心，这些症状未达到GAD或抑郁症的诊断阈值，但在压力下会恶化为明显的焦虑症或抑郁症。
