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Distinguishing between depression and anxiety: A proposal for an extension of the tripartite model

Published online by Cambridge University Press:  16 April 2020

M.E. den Hollander-Gijsman ,
E. de Beurs ,
N.J.A. van der Wee ,
Y.R. van Rood  and
F.G. Zitman
M.E. den Hollander-Gijsman*
Affiliation:
Department of psychiatry, Leiden University Medical Center (LUMC), PO-box 9600, 2300 RCLeiden, The Netherlands Rivierduinen, PO-box 405, 2300 AKLeiden, The Netherlands
E. de Beurs
Affiliation:
Department of psychiatry, Leiden University Medical Center (LUMC), PO-box 9600, 2300 RCLeiden, The Netherlands Netherlands Institute of Forensic Psychiatry and Psychology (NIFP), PO-box 13369, 3507 LJUtrecht, The Netherlands
N.J.A. van der Wee
Affiliation:
Department of psychiatry, Leiden University Medical Center (LUMC), PO-box 9600, 2300 RCLeiden, The Netherlands
Y.R. van Rood
Affiliation:
Department of psychiatry, Leiden University Medical Center (LUMC), PO-box 9600, 2300 RCLeiden, The Netherlands
F.G. Zitman
Affiliation:
Department of psychiatry, Leiden University Medical Center (LUMC), PO-box 9600, 2300 RCLeiden, The Netherlands Rivierduinen, PO-box 405, 2300 AKLeiden, The Netherlands
*
*Corresponding author. Tel.: +31 0 715263785; fax: +31 0 715266964. E-mail address: m.e.den_hollander@lumc.nl (M.E. den Hollander-Gijsman).
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Abstract

Aim

The aim of the current study was to develop scales that assess symptoms of depression and anxiety and can adequately differentiate between depression and anxiety disorders, and also can distinguish within anxiety disorders. As point of departure, we used the tripartite model of Clark and Watson that discerns three dimensions: negative affect, positive affect and physiological hyperarousal.

Methods

Analyses were performed on the data of 1449 patients, who completed the Mood and Anxiety Symptoms Questionnaire (MASQ) and the Brief Symptom Inventory (BSI). From this, 1434 patients were assessed with a standardized diagnostic interview.

Results

A model with five dimensions was found: depressed mood, lack of positive affect, somatic arousal, phobic fear and hostility. The scales appear capable to differentiate between patients with a mood and with an anxiety disorder. Within the anxiety disorders, somatic arousal was specific for patients with panic disorder. Phobic fear was associated with panic disorder, simple phobia and social anxiety disorder, but not with generalized anxiety disorder.

Conclusions

We present a five-factor model as an extension of the tripartite model. Through the addition of phobic fear, anxiety is better represented than in the tripartite model. The new scales are capable to accurately differentiate between depression and anxiety disorders, as well as between several anxiety disorders.

Keywords

Tripartite modelDepressionAnxietyOutpatientsDimensionsQuestionnaires
Type
Original article
Information
European Psychiatry , Volume 25 , Issue 4 , May 2010 , pp. 197 - 205
Copyright
Copyright © Elsevier Masson SAS 2010

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