Correlates and outcomes of depressed out-patients with greater and fewer anxious symptoms: a CO-MED report
Open accessAbstract
The objective of this paper was to determine whether the presence of more vs. fewer anxious symptom features, at baseline, are associated with other clinical features and treatment outcomes in out-patients with major depressive disorder (MDD). This single-blind, randomized trial enrolled 665 MDD out-patients to compare the efficacy of two antidepressant medication combinations against escitalopram after 12-wk acute treatment and follow-up (total 28 wk). The sample was divided into those with greater (vs. fewer) anxiety features using the anxiety/somatization subscale of the baseline 17-item Hamilton Rating Scale for Depression. Baseline sociodemographic and clinical features, treatment features and outcomes compared these two groups. Overall, 74.7% of participants met the threshold for 'anxious features'. They were more likely to be female, have other concurrent anxiety disorders, more severe depression, more lethargic and melancholic features and poorer cognitive and physical functioning, quality of life and work and social adjustment. In acute treatment, participants with anxious features received comparatively higher doses of mirtazapine and venlafaxine and reported more side-effects. The groups with and without anxious features did not differ in treatment outcomes and side-effect burden. Despite being associated with a distinct clinical profile, baseline anxious features were not clinically useful in predicting acute treatment outcomes or differential treatment response.
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A greater side effect severity has been found at various study endpoints in people with anxious depression compared to people with MDD only.
“A greater side effect severity has also been found at various study endpoints in people with anxious depression compared to people with MDD only [13–15].”
From Antidepressant side effects and their impact on treatment outcome in people with major depressive disorder: an iSPOT-D report (2021) · cites this paper as [13]
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Self-citation
- Authors
- Chan, H. N., Rush, A. J., Nierenberg, A. A., Trivedi, M., Wisniewski, S. R., Balasubramani, G. K., Friedman, E. S., Gaynes, B. N., Davis, L., Morris, D., & Fava, M.
- Affiliations
- Singapore General Hospital (SG)
- National University of Singapore (SG)
- Massachusetts General Hospital (US)
- The University of Texas Southwestern Medical Center (US)
- University of Pittsburgh (US)
- University of North Carolina at Chapel Hill (US)
- University of Alabama (US)
- New York State Psychiatric Institute (US)
- Corresponding author
- Trivedi, Madhukar
- ORCID
- Venue
- The International Journal of Neuropsychopharmacology
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-12-01
- Volume
- 15
- Issue
- 10
- Pages
- 1387-1399
- ISSN
- 1461-1457 (ISSN-L)
- 1469-5111
- OpenAlex
- W2149127858
- Cited by
- 30
- References
- 49
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 1
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The International Journal of Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- National University of Singapore (submittedVersion)
- Funders
- Abbott Laboratories
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- University of Texas Southwestern Medical Center
- National Institutes of Health (n01mh90003-26-0-0)
- National Institute of Mental Health (N01‐MH‐90003)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- major depressive disorder, anxiety comorbidity, antidepressant combination therapy, escitalopram, mirtazapine, venlafaxine, treatment response prediction, antidepressant side effects, somatization, endogenous depression, quality of life, work and social adjustment
- MeSH terms
- Adolescent, Adult, Aged, Ambulatory Care, Antidepressive Agents, Anxiety, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Single-Blind Method, Treatment Outcome, Young Adult
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