8. It is said that almost all individuals with mood disorders are also anxious, but not...

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Psychology

8. It is said that almost all individuals with mood disordersare also anxious, but not all those with anxiety disorders showdepressed symptoms. What features do the Mood Disorders share withAnxiety disorders? Describe the characteristics that distinguishthese two classes of disorders. How do these tow groups differ intheir etiology? Their treatment?

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DSM5 provides asomewhat divisive starting point for looking at the overlap betweenmajor depression anxiety disorder and obsessivecompulsivedisorder OCD This is because it proposes a separation betweenanxiety disorders and OCD by placing them in separate chapters ofthe North American diagnostic bibleIn previous versions theyhad been united as anxiety disorders The obsessivecompulsivedisorders include OCD itself body dysmorphic disorder hoardingdisorder trichotillomania and excoriation disorder The anxietydisorders include generalized anxiety disorder GAD specificphobia social phobia agoraphobia and panic disorder These twomajor groups are in turn separated from the trauma andstressorrelated disorders and of course mooddisorderThe diagnostic tradition inmedicine has always been divided between those who have been calledthe lumpers and those called the splitters in other wordsexperts driven by their recognition of the similarities betweendiagnoses and those driven by the differencesSince diagnosis andclassification more generally are a preliminary to more profoundunderstanding of disease neither is wholly right nor whollywrong and as the DSM5 version illustrates the emphasiscan changeTherefore a diagnosis ofmajor depression an anxiety disorder or OCD may make perfectsense in terms of the primary symptoms of which the patientcomplains and on which a differentiated diagnosis is based yetthere may well be a common experience of anxiety and even dysphoriaacross the conditions and of course recourse to the same drug orchoice of drugs for treatment In addressing why this overlapoccurs a common neurobiology seems the most obviousexplanationLumping theevidenceDSM5 itselfadvocates consideration of shared neural substrate family traitsgenetic risk factors specific environmental risk factorsbiomarkers shared temperament abnormalities of emotionalprocessing symptom similarity course of illness highcomorbidity and shared treatment response for confirmingrelationships between diseasesIn fact this use of morenumerous and more global factors leads to the lumping idea ofinternalizing disorders on the one hand into which all thedisorders here fall and externalizing disorders on the othercharacterized by aggression anger outbursts lawbreaking orhyperactivity The introduction of this more dimensional approachto diagnosis in DSM5 also takes note of the likelyadvantages for bridging to neurobiologyTo demonstrate that there isan overlap between depression anxiety disorder and OCD that islikely to rest on shared brain mechanisms it will be important toconsider evidence for shared genes shared brain mechanisms andshared treatment effects However the starting point is theobvious simple overlap of morbid phenomena in the acutepresentation of the different disorders and the commoncooccurrence of full syndromes in the same individuals diagnosedimpartially using DSM criteria The common phenomenologyis typically the experience of fear and anxiety across a very widerange of psychiatric diagnoses Formally the comorbidity of onediagnosis with another beyond chance is the necessary confirmationof a close phenomenological relationship between See Answer

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