Depressive and anxiety disorders are frequently associated. Depression may be a complication of anxiety and anxiety can complicate depression. The nature of their relationship has been a source of controversy. Reviews generally base their conclusions on randomized controlled trials and meta-analyses that refer to the average patient and often clash with the variety of clinical presentations that may occur when anxiety and depression coexist. The aim of this review was to examine the literature according to profiling of subgroups of patients based on clinimetric criteria, in line with the recently developed concept of medicine-based evidence. We critically reviewed the literature pertaining to the specific presentations of anxiety and depression, outlining the advantages and disadvantages of each treatment approach. The following prototypic cases were presented: depression secondary to an active anxiety disorder, depression in patients with anxiety disorders under treatment, anxious depression, anxiety as a residual component of depression, and demoralization secondary to anxiety disorder. We argue that the selection of treatment when anxiety and depression coexist should take into account the modalities of presentation and be filtered by clinical judgment. Very different indications may ensue when the literature is examined according to this perspective.
Psychother Psychosom

中文翻译：

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当焦虑和抑郁并存时：使用临床标准进行鉴别诊断的作用

抑郁症和焦虑症经常联系在一起。抑郁症可能是焦虑症的并发症，而焦虑症会使抑郁症复杂化。他们关系的性质一直是争议的根源。综述通常基于随机对照试验和荟萃分析得出结论，这些试验和荟萃分析涉及普通患者，并且经常与焦虑和抑郁共存时可能出现的各种临床表现相冲突。本综述的目的是根据基于临床标准的患者亚组分析来检查文献，符合最近发展的基于医学证据的概念。我们批判性地回顾了与焦虑和抑郁的具体表现有关的文献，概述了每种治疗方法的优缺点。提出了以下典型案例：继发于活动性焦虑症的抑郁症、接受治疗的焦虑症患者的抑郁症、焦虑性抑郁症、作为抑郁症残留成分的焦虑症以及继发于焦虑症的士气低落。我们认为，当焦虑和抑郁并存时，治疗的选择应考虑到表现的方式，并通过临床判断进行过滤。当根据这种观点检查文献时，可能会出现非常不同的迹象。我们认为，当焦虑和抑郁并存时，治疗的选择应考虑到表现的方式，并通过临床判断进行过滤。当根据这种观点检查文献时，可能会出现非常不同的迹象。我们认为，当焦虑和抑郁并存时，治疗的选择应考虑到表现的方式，并通过临床判断进行过滤。当根据这种观点检查文献时，可能会出现非常不同的迹象。
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