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Trouble anxieux et dépressif mixte : problèmes cliniques

Published online by Cambridge University Press:  16 April 2020

JP Boulenger  and
P Boyer
JP Boulenger
Affiliation:
CHUS, Department of Psychiatry, 3001, 12th Avenue North, Sherbrooke, Québec, JIH 5N4 Canada
P Boyer
Affiliation:
INSERM, Clinique des maladies mentales et de l'encéphale, 100, rue de la Santé, 75014Paris, France
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Résumé

Le trouble anxieux et dépressif mixte (ADM) représente une nouvelle catégorie diagnostique regroupant essentiellement des patients vus dans le cadre des soins primaires. Ces patients se définissent comme des sujets présentant des symptômes d’anxiété et de dépression d’intensité limitée et comparable, s’accompagnant au moins de quelques signes neurovégétatifs. En outre, ces patients sont censés ne pas répondre aux critères diagnostiques spécifiques de troubles anxieux ou dépressifs. Cependant, les cas de dépression anxieuse ne sont pas limités aux patients entrant dans cette nouvelle catégorie « sous-syndromale ». De nombreux patients qui répondent aux critères soit de troubles dépressifs soit de troubles anxieux peuvent également présenter des symptomes, un syndrome ou répondre à un diagnostic d’anxiété ou de dépression. On ne sait pas encore si les symptômes d’anxiété et de dépression sont deux expressions différentes d’un même processus psychopathologique sous-jacent. La description récente d’un « syndrome névrotique généralisé » (Tyrer, 1990) représente une tentative de réunification de syndromes séparés dans nos classifications actuelles. Avec cette approche globale, les états d’anxiété,de dépression ou d’ADM sont associés, à un moment ou à un autre, à des traits de personnalité spécifiques et on considère qu’ils expriment différents niveaux d’hyperréactivité à diverses situations stressantes. Cette hypothèse expliquerait le rapport étroit entre ces deux catégories de symptômes, et I’efficacité dont témoignent certains agents psychopharmacologiques à la fois sur les troubles anxieux et dépressifs.

Keywords

anxiétédépressiontrouble anxieux et dépressif mixte
Type
Research Article
Information
European Psychiatry , Volume 9 , Issue S2: Psychiatrie: quelles convergences pour quelle insertion? , 1994 , pp. 15 - 20
Copyright
Copyright © Elsevier, Paris 1994

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References

Allgulander, CLavori, PWExcess mortality among 3302 patients with pure anxiety neurosis Arch Gen Psychiatry 1991; 48: 599–602CrossRefGoogle ScholarPubMed
Barlow, DHDi Nardo, PAVermilyea, BBVermilyea, JBlanchard, EBComorbidity and depression among the anxiety disorders: issues in diagnosis and classification J Nerv Ment Dis 1986; 174: 63–72CrossRefGoogle ScholarPubMed
Barrett, JEBarrett, JAOxman, TEGerber, PDThe prevalence of psychiatric disorders in a primary care practice Arch Gen Psychiatry 1988; 45: 1100–6CrossRefGoogle Scholar
Beck, ATSteer, RASanderson, WCMadland Skeie, TPanic disorder and suicidal ideation and behavior: discrepant findings in psychiatric outpatients Am J Psychiatry 1991; 148: 1195–9Google ScholarPubMed
Boulenger, JPLavallée, YJAnxiété ou dépression: dilemme diagnostique ou thérapeutique? Concours Méd (Paris) 1991; 113: 1799–804Google Scholar
Breier, ACharney, DSHeinger, GRet al The diagnostic validity of anxiety disorders and their relationship to depressive illness Am J Psychiatry 1985; 142, 7: 787–97Google ScholarPubMed
CIM 10. Dixiéme révision de la classification internationale des maladies. Version française provisoire. Organisation Mondiale de la Same, 1991Google Scholar
Clark, LA The anxiety and depressive disorders: descriptive psychopathology and differential diagnosis. In: Kendall, PCWatson, D eds. Anxiety and Depression: Distinctive and Overlapping Features. San Diego: Academic Press, 1989;83–129Google Scholar
Clark, LAWatson, DTripartite model of anxiety and depression: psychometric evidence and taxonomic implications. J Abnorm Psychol 1991;100:316–36CrossRefGoogle ScholarPubMed
Clayton, PJGrove, WMCoryell, WKeller, MHirschfeld, RFawcett, JFollow-up and family study of anxious depression. Am J Psychiatry 1991;148:1512–7Google ScholarPubMed
Cloninger, CRComorbidity of anxiety and depression. J Clin Psychopharmacol 1990;10:43s–6SCrossRefGoogle ScholarPubMed
Coryell, WEndicott, JAndreasen, NJDepression and panic attacks: the significance of overlap as reflected in follow-up and family study data. Am J Psychiatry 1988;145;3:293–300Google ScholarPubMed
Eaton, WWRitter, CDistinguishing anxiety and depression with field survey data. Psychol Med 1988;155–66CrossRefGoogle ScholarPubMed
France, AWakefield Davis, WKline, MPincus, HFirst, MWidiger, TThe DSM IV field trials: moving towards an empirically derived classification. Eur Psychiatry 1991;6:307–14Google Scholar
Guelfi, JDLa comorbidité anxiété dépression et son traitement. Encéphale 1993;19:397–404Google Scholar
Hiller, WZaudig, MBose, MVThe overlap between depression and anxiety on different levels of psychopathology. J Affective Disord 1989;16:223–31CrossRefGoogle ScholarPubMed
Johnson, JWeissman, MMKlerman GL, Panic disorder, comorbidity and suicide attempts. Arch Gen Psychiatry 1990;9:805–8CrossRefGoogle Scholar
Katon, WRoy-Byrne, PPMixed anxiety depression. J Abnorm Psychol 1991;100:337–45CrossRefGoogle Scholar
Moras, K Diagnostic comorbidity in the DSM III and DSM III-R: anxiety and mood disorders; implications for the DSM IV (1989, unpublished manuscript)>>Google Scholar
Munjack, DJMoss, HBAffective disorders and alcoholism. Arch Gen Psychiatry 1981;38:869–71CrossRefGoogle ScholarPubMed
Ormel, JKoeter, MWJVan den Brink, WVan de Willige, GRecognition management and course of anxiety and depression in general practice. Arch Gen Psychiatry 1991;48:700–6CrossRefGoogle ScholarPubMed
Raskin, ARole of depression in the antipatic effects of antidepressant drugs.In: Ballenger, JC ed. Clinical Aspects of Panic Disorders. Wiley Liss: New York, 1990;169–80Google Scholar
Reich, JTroughton, EComparison of DSM III personality disorders in recovered depressed and panic disorder patients. J Nerv Ment Dis 1988;176:300–4CrossRefGoogle ScholarPubMed
Riskind, JHMoore, RHarman, BHohmann, AABeck, ATStewart, BThe relation of generalized anxiety disorder to depression in general and dysthymic disorder in particular. In: Rapee, RMBarlow, DH eds. Chronic Anxiety, Generalized Anxiety Disorder and Mixed Anxiety-Depression. New York: Guilford Press, 1991:153–71Google Scholar
Sanderson, WCWetzler, SChronic anxiety and generalized anxiety disorders: issues in comorbidity.In: Rapee, RMBarlow, DH eds. Chronic Anxiety, Generalized Anxiety Disorder and Mixed Anxiety-Depression. New York: Guilford Press, 1991:119Google Scholar
Saviotti, FMGrandi, SSavron, GErmentini, RBartolucci, GConti, SFava, GACharacterological traits of recovered patients with panic disorder and agoraphobia. J Affective Disord 1991;23:113–17CrossRefGoogle ScholarPubMed
Shea, MTPilkonis, PABeckham, ECollins, JFElkin, ISotsky, SMDocherty, JPPersonality disorders and treatment outcome in the NIMH treatment of depression collaborative research program. Am J Psychiatry 1990;147:711–18Google ScholarPubMed
Stavrakaki, CVargo, BThe relationship of anxiety and depression: a review of the literature. Br J Psychiatry 1986;149:7–16CrossRefGoogle ScholarPubMed
Stein, MBTancer, MEGelernter, CSVittone, BJUhde, TWMajor depression in patients with social phobia. Am J Psychiatry 1990;147:637–9Google ScholarPubMed
Tyrer, PSeivewnght, NFerguson, Bet al. The Nottingham Study of neurotic disorder: relationship between personality status and symptoms. Psychol Med 1990;20:423–31CrossRefGoogle Scholar
Van Ameringen, MMancini, CStyan, GDoninson, DRelationship of social phobia with other psychiatric illness. J Affective Disord 1991;21:93–9CrossRefGoogle ScholarPubMed
Von Korff, MShapiro, SBurke, JDet al. Anxiety and depression in a primary care clinic. Arch Gen Psychiatry 1987;44:152–6CrossRefGoogle Scholar
Weissmann, MMKlerman, GLMarkowitz, JSQuellette, RSuicidal ideation and suicide attempts in panic disorder and attacks. N Engl J Med 1989;321:1209–14CrossRefGoogle Scholar
Wetzler, SKatz, MMProblems with the differentiation of anxiety and depression. J Psychiatr Res 1989;23:1–12CrossRefGoogle ScholarPubMed
Wittchen, HUNatural course and spontaneous remission of untreated anxiety disorders: results of the Munich Follow-up Study.In: von Zerssen, DWittchen, HU eds. Panic and Phobias: Treatments and Variables Affecting the Outcome. Berlin: Springer Verlag, 1988Google Scholar
Wittchen, HUEssau, CAKrieg, JCAnxiety disorders: similarities and differences of comorbidity in treated and untreated groups. Br J Psychiatry 1991;159 (suppl 12):23–33CrossRefGoogle Scholar
Zinbarg, REBarlow, DHMixed anxiety-depression: a new diagnostic category?In: Rapee, RMBarlow, DH eds. Chronic Anxiety Generalized Anxiety Disorder and Mixed Anxiety-Depression. New York:Guilford Press, 1991;136–52Google Scholar
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