Treatment Of Depression Comorbid With Gad Ocd And Ptsd

In the treatment of comorbidity, the clinician has to choose whether to treat the disorders simultaneously or sequentially. Few guidelines exist for the treatment of comorbidity between depression and GAD, OCD, and PTSD, although it has been suggested that depression should be treated prior to treatment of OCD (Abramowitz, 2004). In addition, results from treatment outcome research suggest that if the primary anxiety disorder is treated, depressive symptoms do improve (i.e., Ehlers et al., 2005).

Irrespective of whether the disorders are treated simultaneously or sequentially, it is important to monitor both conditions consistently throughout treatment to gauge the progress of therapy and to reconsider the plan if treatment progress is not optimal. We recommend that whether to treat the disorders concurrently or sequentially be decided on a case-by-case basis, based on the case formulation. For example, if the assessment suggests that the anxiety disorder is primary and of greater severity than the depression, then incorporating CT protocols developed for the treatment of GAD (i.e., Brown et al., 2001), OCD (i.e., Salkovskis, 1999), or PTSD (i.e., Ehlers & Clark, 2000) is warranted.

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