Recent advances in the study of the comorbidity of depressive and anxiety disorders

Abstract

Depressive and anxiety disorders often comorbid, which causes more severe impairments. The high comorbidity and shared genetic and psychological factors between the 2 disorders have brought arguments about whether they represent a common construct, and whether the current classification is meaningful. In this editorial, a state-of-the-art overview of recent studies on the underlying mechanism of such comorbidity, and the association between and differentiation of the 2 disorders is provided. Recent studies employing data-driven approaches such as latent class analysis (LCA) and network analysis to investigate the symptomatology of depression and anxiety have indicated unique characteristics and bridging symptoms of their comorbidity. Whereas previous neurobiological and neuroendocrinological studies reported common alterations in prefrontal-limbic pathways, serotonergic projections and the hypothalamic-pituitary-adrenal (HPA) axis, recent research suggests that distinct neural circuits and heterogeneous changes in HPA activity may exist in depression when compared to anxiety. Lastly, both depression and anxiety have been long associated with decision-making deficits; however, emerging evidence from computational psychiatry demonstrate that there may be unique neurocognitive and computational alterations in each disorder. By investigating the common and unique symptomatic characteristics and underlying neurobiological and neurocomputational mechanisms of the 2 disorders as well as their comorbidity, it can be concluded that recent studies have greatly advanced our understanding of the etiology and neuropathophysiology of these disorders.