The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid conditions

Results from epidemiological and clinical studies indicate that psychiatric and medical comorbidity occurs at a high rate among individuals with major depressive disorder (MDD) and bipolar disorder (BD). Comorbidity in mood disorders has diagnostic, prognostic, therapeutic, and conceptual implications. For example, comorbid substance use may obscure an underlying mood disorder, delay initiation of treatment, alter the determination of the most appropriate therapy, and challenge the clinician’s development of an etiological understanding of the patient’s condition. Moreover, an association between comorbid conditions and more complicated mood disorder presentations has been documented, with evidence of increased rates of chronicity, nonrecovery, suicidality, and premature ] mortality in comorbid patients. From a treatment perspective, the probability of achieving full recovery from an index affective episode is significantly decreased in the presence of comorbidity, and in many cases, treating a comorbid condition could inadvertently disrupt management of the mood disorder (eg, using antidepressants to treat an anxiety disorder in an adult with bipolar I disorder)…

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