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: 1.69). 01/2011; 199(1):42-8. DOI: 10.1097/NMD.0b013e3182043b60
Source: PubMed


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.

Download full-text


Available from: Tae-Youn Jun, Apr 05, 2014
  • Source
    • "Somatic anxiety corresponding to tension has also been seen as a distinctive aspect of MDD symptomatology.49 Another finding of the CRESCEND study is that suicidal ideation is more closely associated with anxious depression than non-anxious depression.50 Hence, it is remarkable that emotional withdrawal, tension, and suicidal ideation are distinctive clinical correlates of PMD. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective The 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). Methods We 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. Results PMD 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. Conclusion Our 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.
    Full-text · Article · Jul 2014 · Psychiatry investigation
  • Source
    • "Markedly higher levels of overall psychopathology characterize suicide attempters, as indicated by a more severe depression and a higher prevalence of co-morbid disorders. Psychiatric out-patients with major depressive disorder have a high level of comorbidity with general anxiety disorder (Seo et al. 2011), social phobia, situational phobia, all of which independently implicate elevated risk for suicidal ideation and suicidal plan. This finding corroborates "
    B Bi · X Xiao · H Zhang · J Gao · M Tao · H Niu · Y Wang · Q Wang · C Chen · N Sun · [...] · J Guan · Z Kang · D Di · Yajuan Li · S Shi · Yihan Li · Y Chen · J Flint · K Kendler · Y Liu ·
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: The relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms.Method We examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD. RESULTS: Suicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9-6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt. CONCLUSIONS: This study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide.
    Full-text · Article · Apr 2012 · Psychological Medicine
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: This study aimed to determine whether major depressive disorders with melancholic and without melancholic features differ with respect to their responses to treatment with antidepressants. METHODS: From a nationwide sample of 18 hospitals in South Korea, 559 presenting patients with major depressive disorder were recruited. The DSM-IV based Structured Clinical Interview was administered for confirmatory diagnoses and depression subtypes with/without melancholic features. After baseline evaluation, they received naturalistic clinician-determined antidepressant interventions. Assessment scales for evaluating depression (HAMD), anxiety (HAMA), global severity (CGI-s), and functioning (SOFAS) were administered at baseline and re-evaluated at 1, 2, 4, 8, and 12 weeks later. RESULTS: At baseline, the 243 (43.5%) participants with melancholic features were more likely to have a previous history of depression, and had higher HAMA and lower SOFAS scores. After adjustment for baseline status, participants with melancholic features were more likely to achieve and to experience shorter times to CGI-s remission and associated with an enhanced global symptomatic remission with any antidepressant treatment. They were more likely to achieve and to experience shorter times to CGI-s remission and this difference was strongest in those receiving selective serotonin reuptake inhibitor (SSRI) antidepressants treatment. LIMITATIONS: The study was observational, and the treatment modality was naturalistic. CONCLUSIONS: These findings suggest a faster and more evident global response to pharmacotherapy in melancholia compared to other depressive syndromes, particularly where SSRI agents are used.
    Full-text · Article · Jul 2012 · Journal of Affective Disorders
Show more