Difference in remission in a Chinese population with anxious versus nonanxious treatment-resistant depression: a report of OPERATION study
Abstract
Background A secondary analysis was conducted to compare treatment outcomes for anxious depression and nonanxious depression in previous published OPERATION trials of a variety of antidepressants and augmentation strategies for patients with treatment-resistant depression (TRD).Methods A total of 375 patients that met DSM-IV criteria for major depressive disorder (MDD) and the stage 2 TRD criteria (described by Thase & Rush) were enrolled. Anxious depression was defined as MDD with a HRSD-17 anxiety/somatization factor score ≥7. Data were derived from an earlier study, designed to compare efficacy and tolerability of fixed dosage of extended-release venlafaxine, mitazapine, paroxetine, and risperidone, sodium valproate, buspirone, trazodone or thyroid hormone augmenting to paroxetine in those patients. Treatment outcomes were compared between patients with anxious and nonanxious TRD.Results Nearly 70% of participants had anxious depression. Remission rates were significantly lower and ratings of adverse event frequency were significantly greater in patients with anxious TRD than in those with nonanxious TRD. Presence of anxious depression predicted worse outcomes.Limitations Lack of a placebo control arm prevents us from ruling out placebo effects. The two groups were non-randomly allocated to medications. Only patients with stage 2 TRD were enrolled, which may limit generalizablity to patients without a history of resistance. Comorbid anxiety disorders that might confound the specific treatment effects were not addressed.Conclusions The findings support and extend the hypothesis that anxious depression is associated with poorer outcomes. It suggests a dimensional assessment of co-occurring anxious features of MDD patients may be clinically feasible for countries like China where difficulties in making comorbidity diagnosis exist.
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A Chinese population study using the same definition found that 70% of 375 MDD patients had anxious depression.
“and a Chinese population study using the same definition, found that 70% of 375 MDD patients had anxious depression [13].”
From Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome (2018) · cites this paper as [13]
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DSM-5의 불안성 디스트레스 세부 진단에 따른 주요우울장애 입원 환자의 약물치료 반응의 차이
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- Authors
- Wu, Z., Chen, J., Yuan, C., Hong, W., Peng, D., Zhang, C., Cao, L., & Fang, Y.
- Affiliations
- Shanghai Jiao Tong University (CN)
- Corresponding author
- Fang, Yiru
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 150
- Issue
- 3
- Pages
- 834-839
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W1970407368
- Cited by
- 77
- References
- 28
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 10 · 2023: 2 · 2022: 8 · 2021: 4 · 2020: 4 · 2019: 10 · 2018: 13 · 2017: 4 · 2016: 3 · 2015: 5 · 2014: 3 · 2013: 2
- FWCI
- 3.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- treatment-resistant depression, anxious depression, remission, major depressive disorder, antidepressant augmentation, venlafaxine, paroxetine, risperidone, valproic acid, buspirone, trazodone, adverse events, anxiety comorbidity, Chinese patients
- MeSH terms
- Venlafaxine Hydrochloride, Adolescent, Adult, Aged, Antidepressive Agents, Anxiety Disorders, Buspirone, China, Cyclohexanols, Major Depressive Disorder, Double-Blind Method, Female, Humans, Male, Middle Aged, Remission Induction, Comorbidity, Treatment Outcome, Paroxetine, Risperidone, Young Adult, Depressive Disorder, Treatment-Resistant
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