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.

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    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.
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May 29, 2014