Comorbid depression and treatment of anxiety disorders, OCD, and PTSD: Diagnosis versus severity.

BACKGROUND: Although anxiety and depression are highly comorbid disorders, it remains unclear whether and how a concurrent depression affects the outcome of anxiety treatment. METHOD: Using anonymized routine outcome monitoring (ROM) data of 740 patients having received specialized treatment for an anxiety disorder, OCD, or PTSD, this study investigates whether a comorbid diagnosis of depression and/or self-reported depression severity levels relate to the patients' improvement following anxiety treatment. RESULTS: The results show that both the patients with and those without comorbid depression had profited similarly from the anxiety, OCD, or PTSD treatment, regardless of whether depression was merely diagnosed prior to treatment or based on self-reported severity (and assuming a smallest effect size of interest of d = 0.35/r = .2). Importantly, the post-treatment reductions in self-reported depressive symptoms were strongly and positively related to the reductions in self-reported anxiety symptoms and disorder-related disability. LIMITATIONS: Causal inferences cannot be made due to the retrospective cross-sectional design. CONCLUSIONS: The outcomes obtained in a naturalistic patient sample support current treatment guidelines recommending evidence-based treatment for anxiety disorders, OCD, and PTSD in patients with and without a comorbid depression. Future treatment studies are recommended for investigate the (bi)directionality of anxiety and depressive symptoms throughout treatment.

Route choices, migration speeds and daily migration activity of European silver eels Anguilla anguilla in the River Rhine, north-west Europe.

Downstream migration of Anguilla anguilla silver eels was studied in the Lower Rhine, Germany, and the Rhine Delta, The Netherlands, in 2004-2006. Fish (n = 457) released near Cologne with implanted transponders were tracked by remote telemetry at 12 fixed detection locations distributed along the different possible migration routes to the North Sea. Relatively more A. anguilla migrated via the Waal than the Nederrijn, as would be expected from the ratio of river discharges at the bifurcation point at Pannerden. Downstream migration from the release site to Rhine-Xanten, close to the German-Dutch border, generally occurred in the autumn of the year of release but migration speeds tended to be low and variable and unaffected by maturation status or river discharge rates. Detection frequencies were not significantly related to discharge peaks or lunar cycles, but there was a minor detection peak 1-6 h after sunset. Between 2004 and 2009, 43% of the 457 A. anguilla released were never detected and of the 260 detected entering the Netherlands, 83 (32%) were detected escaping to the sea, 78 (94%) via the Nieuwe Waterweg and three (4%) and two (2%) via the sluices in the Haringvlietdam and Afsluitdijk, respectively. Possible causes of non-detections are discussed and it is suggested that many A. anguilla temporarily ceased migration, but that fishing mortality could have been important during passage through the Dutch parts of the Rhine. Practical implications of the results for predicting emigration routes, timings and magnitudes and use in management initiatives to promote escapement of A. anguilla silver eels to the sea are critically discussed.