Anxious depression and early changes in the HAMD-17 anxiety-somatization factor items and antidepressant treatment outcome.
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The objective of this study was to assess the relationship between early changes in anxiety/somatization symptoms and treatment outcome among major depressive disorder patients during a 12-week trial of fluoxetine. We also examined the relationship between anxious depression and treatment response. Five hundred and ten major depressive disorder patients received 12 weeks of fluoxetine with flexible dosing [target dosages: 10 mg/day (week 1), 20 mg/day (weeks 2-4), 40 mg/day (weeks 4-8), and 60 mg/day (weeks 5-12)]. We assessed the relationship between early changes in 17-item Hamilton Rating Scale for Depression (HAMD-17)-anxiety/somatization factor items and depressive remission, as well as whether anxious depression at baseline predicted remission at study endpoint. Baseline HAMD-17 scores were considered as covariates and the Bonferroni correction (P < or = 0.008) was used for multiple comparisons. Adjusting for baseline HAMD-17 scores, patients who experienced greater early improvement in somatic symptoms (gastrointestinal) were significantly more likely to attain remission (HAMD-17 <8) at endpoint than those without early improvement (P=0.006). Early changes in the remaining items did not predict remission, nor did anxious depression at baseline. In conclusion, among the anxiety/somatization factor items, only early changes in somatic symptoms (gastrointestinal) predicted remission. Future studies are warranted to further investigate this relationship as well as that between anxious depression and treatment outcome.
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GAD and conceptually related conditions lag behind in treatment efficacy compared to other anxiety and mood disorders, make otherwise efficacious interventions for MDD refractory, and are associated with difficulties maintaining durability of comorbid MDD gains over the long term.
“GAD, and conceptually related conditions (e.g., MDD with anxious apprehensive features) lag behind in treatment efficacy compared to other anxiety and mood disorders6, makes otherwise efficacious interventions for MDD refractory7, and are associated with notable difficulties in maintaining durability of comorbid MDD gains over the long term8.”
From AN OPEN TRIAL OF EMOTION REGULATION THERAPY FOR GENERALIZED ANXIETY DISORDER AND COOCCURRING DEPRESSION. (2015) · cites this paper as [7]
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Experimental — accuracy not yet measuredWhen GAD and MDD co-occur, they are associated with increased public health burden and are more treatment refractory.
“When they co-occur, GAD and MDD are associated with increased public health burden and are more treatment refractory (e.g., Whisman et al., 2000; Stein and Heimberg, 2004; Farabaugh et al., 2010; Newman et al., 2010; Tully et al., 2013).”
From Distinct functional connectivities predict clinical response with emotion regulation therapy (2017) · cites this paper as Farabaugh et al., 2010
The Methods and Results (pages unavailable) examine anxious symptoms in patients with MDD, not co-occurring GAD and MDD. The Results report that baseline anxious depression did not predict remission, but do not address treatment refractoriness or public-health burden in people with both diagnoses. Searches for GAD, comorbidity, treatment refractoriness, and public-health burden found no passage establishing the attributed claim. (LLM, conf=0.76)
Experimental — accuracy not yet measuredIn the STAR*D study, the subgroup with mixed anxiety-depressive disorder was most treatment refractory.
“the subgroup of patients who evidenced the weakest treatment gains reflected a clinical presentation of mixed anxiety-depressive disorder (e.g., MDD + apprehensive anxious symptoms) was most treatment refractory (Farabaugh et al., 2010).”
From Emotion Regulation Therapy: A Mechanism-Targeted Treatment for Disorders of Distress (2017) · cites this paper as Farabaugh et al., 2010
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- Authors
- Farabaugh, A. H., Bitran, S., Witte, J., Alpert, J., Chuzi, S., Clain, A. J., Baer, L., Fava, M., McGrath, P. J., Dording, C., Mischoulon, D., & Papakostas, G. I.
- Affiliations
- Harvard University (US)
- New York State Psychiatric Institute (US)
- Corresponding author
- Farabaugh, Amy H.
- Venue
- International Clinical Psychopharmacology
- Published
- 2010-07
- Volume
- 25
- Issue
- 4
- Pages
- 214-217
- ISSN
- 0268-1315 (ISSN-L)
- PMC
- PMC2909033
- OpenAlex
- W2000461728
- Cited by
- 37
- References
- 15
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 1 · 2021: 2 · 2020: 2 · 2019: 8 · 2018: 4 · 2017: 3 · 2016: 1 · 2015: 3 · 2014: 4 · 2013: 3 · 2012: 1
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- U.S. Public Health Service (R10 MG56058)
- National Institute of Mental Health (R10MH056058, R10MH056057)
- 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 › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- anxious depression, somatization, anxiety symptoms, gastrointestinal symptoms, fluoxetine, antidepressant treatment outcome, early treatment response, major depressive disorder
- MeSH terms
- Adult, Anxiety, Major Depressive Disorder, Female, Fluoxetine, Gastrointestinal Diseases, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Remission Induction, Treatment Outcome, Antidepressive Agents, Second-Generation
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