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Cited by 406Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major DepressionMental Health Treatment and Access

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

FAVA, MAURIZIO, ALPERT, JONATHAN E., CARMIN, CHERYL N., WISNIEWSKI, STEPHEN R., TRIVEDI, MADHUKAR H., BIGGS, MELANIE M., SHORES-WILSON, KATHY, MORGAN, DON +3 more·2004·Psychological Medicine
DOI 10.1017/s0033291704002612
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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 > or =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).

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  • Depressed patients with anxiety symptoms measured with the HAM-D ASF or HAM-A generally have greater depression chronicity and severity, higher suicide ideation and risks, and lower quality of life than MDD patients without anxiety.

    “Either measured with the HAM-D ASF score or HAM-A, depressed patients with anxiety symptoms generally have greater depression chronicity and severity [1,5,6], higher suicide ideation and risks [1,8,9], and lower QOL than MDD patients without anxiety.”

    From Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome (2018) · cites this paper as [5]

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Authors
FAVA, M., ALPERT, J. E., CARMIN, C. N., WISNIEWSKI, S. R., TRIVEDI, M. H., BIGGS, M. M., SHORES-WILSON, K., MORGAN, D., SCHWARTZ, T., BALASUBRAMANI, G. K., & JOHN RUSH, A.
Affiliations
University of Kansas (US)
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2004-10
Volume
34
Issue
7
Pages
1299-1308
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291704002612
OpenAlex
W1964640782
Cited by
406
References
31
Citations by year
2026: 21 · 2025: 27 · 2024: 25 · 2023: 34 · 2022: 29 · 2021: 18 · 2020: 23 · 2019: 16 · 2018: 16 · 2017: 17 · 2016: 16 · 2015: 18 · 2014: 14 · 2013: 19 · 2012: 13
FWCI
10.44
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified, 20 d)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Sanofi
  • National Institutes of Health (n01mh90003-26-0-0)
  • National Institute of Mental Health (N01‐MH‐90003)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
anxious depression, major depressive disorder, anxiety symptoms, depression subtypes, prevalence, comorbid psychiatric symptoms, generalized anxiety disorder, obsessive-compulsive symptoms, panic disorder, post-traumatic stress disorder, agoraphobia, health anxiety, somatoform disorders, endogenous depression, atypical depression, suicidal ideation, STAR*D
MeSH terms
Adolescent, Adult, Aged, Antidepressive Agents, Anxiety Disorders, Cross-Sectional Studies, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Personality Assessment, Personality Inventory, Primary Health Care, Prospective Studies, Somatoform Disorders, Statistics as Topic, Cohort Studies, Comorbidity, Treatment Outcome

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