Table 2.

Mixed anxiety and depressive disorder—diagnostic guidelines for ICD-10 in primary care [16]

Presenting complaints

The patient presents with variety of symptoms of anxiety and depression

There may initially be one or more physical symptoms (e.g., fatigue, pain). Further enquiry will reveal depressed mood and/or anxiety

Diagnostic features

Low or sad mood

Loss of interest or pleasure

Prominent anxiety or worry

The following associated symptoms are frequently present: disturbed sleep, tremor, fatigue or loss of energy, palpitations, poor concentration, dizziness, disturbed appetite, suicidal thoughts or acts, dry mouth, loss of libido, tension, and restlessness

Differential diagnosis

If more severe symptoms of depression or anxiety are present, see management guidelines for Depression—F32 and Generalized anxiety—F41.1

If somatic symptoms predominate, see Unexplained somatic symptoms—F45

If the patient has a history of manic episodes (excitement, elevated mood, rapid speech), see Bipolar disorder—F31

If heavy alcohol or drug use is present, see Alcohol use disorders—F10 and Drug use disorders—F11