cosas de psicologia

ANSIEDAD Y DEPRESIÓN: EL PROBLEMA
DE LA DIFERENCIACIÓN A TRAVÉS DE LOS SÍNTOMAS
Diana Agudelo*, Gualberto Buela-Casal*, Charles Donald Spielberger**

SUMMARY
The differentiation between the symptoms of anxiety and depression is one of the most important problems in psychology as the
dilemma profoundly affects the diagnosis and clinical intervention.
According to the epidemiological datathere is a strong
comorbility between the two types of disorder. Nevertheless, it is
not known which one of them precedes or predisposes to the
other. The comorbility could be also caused by the confusion between the two. There are many common symptoms and some of
them traditionally attributed to the anxiety are also present in depression and vice versa. Additionally, in some cases the symptomsthemselves could constitute complete clinical charts.
Taking into account the above description, one of the most
important current preoccupations in psychology and psychopathology is the identification of the symptoms which would be
characteristic for each disorder. Although there is clinical evidence
on an overlap between the symptoms, the current manuals describe two disorders and theclinical differences are crucial.
One of the possible explanations of the overlap between the
symptoms of anxiety and depression has been classically attributed to comorbility which means the presence of both charts in
many clinical cases. Different sources indicate that the presence
of anxiety in early ages can generate certain vulnerability to develop later-age major depression. On the otherhand, other studies indicate that the cases in which both, depression and anxiety
are present, tend to chronify and are more resistant to treatment.
In this case both disorders are present but there is no sufficient
evidence to determinate which one of them would be the principal diagnosis and which one would be secondary. For this reason,
the explanations are confused and neither the researchersnor clinicians are satisfied.
On the other hand, the concurrence of symptoms has been attributed to the instruments utilized for the evaluation. The disorders also depend on the tools for their measure which follow a theoretical model to explain the aetiology, course, prognosis and associated symptomatology. This way, the implicit bias of the instruments
is to privilege a specific aspect whichdepends on the definition of
disorders without taking into account the other aspects.
According the description above, the evaluation, especially in
case of depression, is characterized by multiplicity of instruments
and diversity of contents which are evaluated. Thus, it is difficult
to establish the characteristic symptoms as in many cases only

some of them coincide when utilizingdifferent tools. Moreover,
many symptoms which are detected by scales of depression are
also present in anxiety disorders. This difficulty is one of the most
important problems in clinics as it affects the validity and reliability of the tools which assess the disorders.
The importance of the instructions given to the subjects should
also be emphasized. In many cases they lead to the confusion ofthe measures of frequency and severity which is related to the classical discussion about the dimensional or categorical character of
depression. Some authors state that the consideration of depression as a dimensional disorder makes possible to understand that
some charts, as for example the anxiety disorders, can appear as a
consequence of certain vulnerability generated by the depression.One of the alternatives to explain the presence of symptoms
shared by the anxiety and depression is to consider the existence
of a factor of negative affect which would be present in both
types of disorder. This point of view is derived from the correspondence between some common symptoms in depression and
anxiety observed in clinics. Additionally, some items included in
the self-report...