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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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