The relationship between depression and generalized anxiety during intensive psychological and pharmacological treatment

Idan M. Aderka, Courtney Beard, Josephine Lee, Rachel B. Weiss, Thröstur Björgvinsson

Research output: Contribution to journalArticlepeer-review


Background In the present study we examined the relationship between depressive symptoms and generalized anxiety symptoms during intensive cognitive-behavioral and pharmacological treatment. Method: Individuals (n=157) with major depressive disorder (MDD; n=83), generalized anxiety disorder (GAD; n=29) and their combination (n=45) who attended an intensive partial hospital treatment program, completed daily self-report measures of depression and generalized anxiety. Treatment included empirically-based cognitive-behavioral interventions in both individual and group format, as well as pharmacotherapy. Results Multilevel linear modeling indicated that for all diagnostic groups, changes in depressive symptoms led to changes in generalized anxiety symptoms to a greater extent than vice versa during treatment. Moreover, changes in depressive symptoms fully mediated changes in generalized anxiety symptoms, whereas changes in generalized anxiety symptoms only partially mediated the changes in depressive symptoms. Limitations Partial hospital setting. Conclusions Our results suggest that depressive symptoms may play a prominent role in the process of change in both MDD and GAD. This has implications for the classification of GAD as well as for choosing early treatment targets for individuals with comorbid MDD and GAD.

Original languageEnglish
Pages (from-to)261-268
Number of pages8
JournalJournal of Affective Disorders
StatePublished - 29 Jun 2015

Bibliographical note

Publisher Copyright:
© 2015 Elsevier B.V.All rights reserved.


  • Cognitive behavior therapy
  • Comorbidity
  • Generalized anxiety disorder
  • Lower level mediational modeling
  • Major depressive disorder

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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