Distinctive clinical characteristics and suicidal tendencies of patients with anxious depression.

Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
The Journal of nervous and mental disease (Impact Factor: 1.81). 01/2011; 199(1):42-8. DOI: 10.1097/NMD.0b013e3182043b60
Source: PubMed

ABSTRACT This study evaluated clinical characteristics and suicidality of patients with anxious depression in a large cohort of samples. Data were collected from 1003 patients who were depressed. A total of 461 patients were diagnosed with anxious depression and 542 were diagnosed with nonanxious depression. After adjusting for the severity of depression, those in the anxious depression group had significantly younger onset age, had been suffering from depression for a longer period, were more likely to experience a recurrence, and obtained lower scores on a scale assessing quality of life. The anxious depression group was characterized by a significantly higher proportion of individuals reporting significant suicidal ideation and previous suicide attempts, and those in this group tended to obtain higher scores on the Scale for Suicide Ideation. The present findings that were drawn from detailed evaluation of suicidality strongly support previous results assessed only with the help of clinical reports. More attention should be paid to assess suicide risk in these patients.


Available from: Tae-Youn Jun, Apr 05, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Desvenlafaxine (administered as desvenlafaxine succinate) for anxious depression was assessed in a post hoc analysis.Methods Data were pooled from patients randomly assigned to desvenlafaxine 50 mg/day or placebo in seven double-blind, fixed-dose studies in adults with major depressive disorder. Patients with “anxious depression” had baseline 17-item Hamilton Rating Scale for Depression, anxiety–somatization factor (HAM-D17 A/S) scores ≥7. Primary end point was change in HAM-D17 scores from baseline at week 8 (last observation carried forward), evaluated using analysis of covariance with treatment, study, and baseline value as covariates.ResultsA total of 1873/2706 (69%) patients were identified as “anxious depressed”. Desvenlafaxine significantly improved HAM-D17 total scores versus placebo in anxious (adjusted mean [95% CI] −1.72 [−2.35, −1.09]; p < 0.001) and nonanxious (−1.48 [−2.40, −0.57]; p = 0.002) populations, with no significant treatment-by-anxiety interaction. Response and remission rates (HAM-D17) were significantly higher with desvenlafaxine compared with placebo in both populations. Treatment-emergent adverse events were reported by 78% and 69% (desvenlafaxine versus placebo, respectively) of anxious depressed patients and by 77% and 68% of nonanxious patients.Conclusion Desvenlafaxine 50 mg/day significantly improved depressive symptoms compared with placebo in major depressive disorder patients with clinically relevant anxiety symptoms. Improvement in the HAM-D17 total score was similar for anxious/nonanxious groups. Copyright © 2014 John Wiley & Sons, Ltd.
    Human Psychopharmacology Clinical and Experimental 09/2014; 29(5). DOI:10.1002/hup.2427 · 1.85 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To investigate whether the anxious depression defined as depression with clinically significant anxiety but not comorbid anxiety disorder predicts poor outcomes of depression treatment in naturalistic clinical setting. From nationwide sample of 18 hospitals, 674 patients with moderate to severe depression who completed the DSM-IV-based Structured Clinical Interview (SCID) were recruited. Anxious depression was defined as not having comorbid anxiety disorder by SCID and having a Hamilton Rating Scale for Anxiety (HAM-A) total score ≥20. Participants were classified into three groups: anxious depression (N=259), non-anxious depression (N=351), or comorbid anxiety disorder (N=64). Rates of and time to remission and response and changes in scale scores were compared between these groups during 12 weeks treatment with antidepressant interventions freely determined by clinicians. No significant differences were observed in the Hamilton Rating Scale for Depression (HAM-D) remission rate and the time to achieve HAM-D remission between anxious and non-anxious depression after adjustment for variables is not equally distributed at baseline. There were also no significant differences in HAM-D and HAM-A response rate and time to responses between two groups. Patients with comorbid anxiety disorder showed less improvement on HAM-D and HAM-A score than did those with anxious depression despite similar baseline symptom severity. This study was observational, and the treatment modality was naturalistic. Anxious depression did not predict worse outcome to antidepressants treatment. This finding might result from exclusion of comorbid anxiety disorder from anxious depression population and allowance of broad treatment modality.
    Journal of Affective Disorders 10/2013; 152. DOI:10.1016/j.jad.2013.09.037 · 3.71 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: ObjectiveThe purpose of this investigation was to identify distinctive clinical correlates of psychotic major depression (PMD) as compared with non-psychotic major depression (NPMD) in a large cohort of Korean patients with major depressive disorder (MDD).MethodsWe recruited 966 MDD patients of age over 18 years from the Clinical Research Center for Depression of South Korea (CRESCEND) study. Diagnoses of PMD (n=24) and NPMD (n=942) were made with the DSM-IV definitions and confirmed with SCID. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (HAMD), anxiety (HAMA), global severity (CGI-S), suicidal ideation (SSI-Beck), functioning (SOFAS), and quality of life (WHOQOL-BREF). Using independent t-tests and χ2 tests, we compared clinical characteristics of patients with PMD and NPMD. A binary logistic regression model was constructed to identify factors independently associated with increased likelihood of PMD.ResultsPMD subjects were characterized by a higher rate of inpatient enrollment, and higher scores on many items on BPRS (somatic concern, anxiety, emotional withdrawal, guilt feelings, tension, depression, suspiciousness, hallucination, motor retardation, blunted affect and excitement) global severity (CGI-s), and suicidal ideation (SSI-Beck). The explanatory factor model revealed that high levels of tension, excitement, and suicidal ideation were associated with increased likelihood of PMD.ConclusionOur findings partly support the view that PMD has its own distinctive clinical manifestation and course, and may be considered a diagnostic entity separate from NPMD.
    Psychiatry investigation 07/2014; 11(3):281-9. DOI:10.4306/pi.2014.11.3.281 · 1.15 Impact Factor