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Clinical correlates and symptom patterns of anxious depression among patients with major depressive disorder in STAR*D

Published online by Cambridge University Press:  21 October 2004

MAURIZIO FAVA ,
JONATHAN E. ALPERT ,
CHERYL N. CARMIN ,
STEPHEN R. WISNIEWSKI ,
MADHUKAR H. TRIVEDI ,
MELANIE M. BIGGS ,
KATHY SHORES-WILSON ,
DON MORGAN ,
TERRY SCHWARTZ  and
G. K. BALASUBRAMANI
...Show all authors
MAURIZIO FAVA
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
JONATHAN E. ALPERT
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
CHERYL N. CARMIN
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
STEPHEN R. WISNIEWSKI
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
MADHUKAR H. TRIVEDI
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
MELANIE M. BIGGS
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
KATHY SHORES-WILSON
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
DON MORGAN
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
TERRY SCHWARTZ
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
G. K. BALASUBRAMANI
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
A. JOHN RUSH
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; University of Illinois at Chicago, Chicago, IL, USA; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; The University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA; Psychiatric Research Institute, University of Kansas, Wichita, KS, USA; University of California at San Diego Outpatient Psychiatric Services, University of California at San Diego, San Diego, CA, USA
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Abstract

Background. Anxious depression, defined as Major Depressive Disorder (MDD) with high levels of anxiety symptoms, may represent a relatively common depressive subtype, with distinctive features.

Objective. The objective of this study was to determine the prevalence of anxious depression and to define its clinical correlates and symptom patterns.

Method. Baseline clinical and sociodemographic data were collected on 1450 subjects participating in the STAR*D study. A baseline Hamilton Rating Scale for Depression (HAM-D) Anxiety/Somatization factor score of [ges ]7 was considered indicative of anxious depression. The types and degree of concurrent psychiatric symptoms were measured using the Psychiatric Diagnostic Screening Questionnaire (PDSQ), by recording the number of items endorsed by study participants for each diagnostic category. MDD symptoms were assessed by clinical telephone interview with the 30-item Inventory of Depressive Symptomatology (IDS-C30).

Results. The prevalence of anxious depression in this population was 46%. Patients with anxious MDD were significantly more likely to be older, unemployed, less educated, more severely depressed, and to have suicidal ideation before and after adjustment for severity of depression. As far as concurrent psychiatric symptoms are concerned, patients with anxious depression were significantly more likely to endorse symptoms related to generalized anxiety, obsessive compulsive, panic, post-traumatic stress, agoraphobia, hypochondriasis, and somatoform disorders before and after adjustment for severity of depression. Anxious-depression individuals were also significantly less likely to endorse IDS-C30 items concerning atypical features, and were significantly more likely to endorse items concerning melancholic/endogenous depression features.

Conclusion. This study supports specific clinical and sociodemographic correlates of MDD associated with high levels of anxiety (anxious depression).

Type
Research Article
Information
Psychological Medicine , Volume 34 , Issue 7 , October 2004 , pp. 1299 - 1308
Copyright
© 2004 Cambridge University Press

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