The Clinical Characteristics and Manifestation of Anxious Depression Among Patients With Major Depressive Disorders-Results From a Taiwan Multicenter Study
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective Anxious depression is a prevalent characteristic observed in Asian psychiatric patients diagnosed with major depressive disorder (MDD). This study aims to investigate the prevalence and clinical presentation of anxious depression in Taiwanese individuals diagnosed with MDD.Methods We recruited psychiatric outpatients aged over 18 who had been diagnosed with MDD through clinical interviews. This recruitment took place at five hospitals located in northern Taiwan. We gathered baseline clinical and demographic information from the participants. Anxious depression was identified using a threshold of an anxiety/somatization factor score ≥7 on the 21-item Hamilton Rating Scale for Depression (HAM-D).Results In our study of 399 patients (84.21% female), 64.16% met the criteria for anxious depression. They tended to be older, married, less educated, with more children, and an older age of onset. Anxious depression patients had higher HAM-D and Clinical Global Impression–Severity scale score, more panic disorder (without agoraphobia), and exhibited symptoms like agitation, irritability, concentration difficulties, psychological and somatic anxiety, somatic complaints, hypochondriasis, weight loss, and increased insight. Surprisingly, their suicide rates did not significantly differ from non-anxious depression patients. This highlights the importance of recognizing and addressing these unique characteristics.Conclusion Our study findings unveiled that the prevalence of anxious depression among Taiwanese outpatients diagnosed with MDD was lower compared to inpatients but substantially higher than the reported rates in European countries and the United States. Furthermore, patients with anxious depression exhibited a greater occurrence of somatic symptoms.
Abstract
Objective Anxious depression is a prevalent characteristic observed in Asian psychiatric patients diagnosed with major depressive disorder (MDD). This study aims to investigate the prevalence and clinical presentation of anxious depression in Taiwanese individuals diagnosed with MDD.Methods We recruited psychiatric outpatients aged over 18 who had been diagnosed with MDD through clinical interviews. This recruitment took place at five hospitals located in northern Taiwan. We gathered baseline clinical and demographic information from the participants. Anxious depression was identified using a threshold of an anxiety/somatization factor score ≥7 on the 21-item Hamilton Rating Scale for Depression (HAM-D).Results In our study of 399 patients (84.21% female), 64.16% met the criteria for anxious depression. They tended to be older, married, less educated, with more children, and an older age of onset. Anxious depression patients had higher HAM-D and Clinical Global Impression–Severity scale score, more panic disorder (without agoraphobia), and exhibited symptoms like agitation, irritability, concentration difficulties, psychological and somatic anxiety, somatic complaints, hypochondriasis, weight loss, and increased insight. Surprisingly, their suicide rates did not significantly differ from non-anxious depression patients. This highlights the importance of recognizing and addressing these unique characteristics.Conclusion Our study findings unveiled that the prevalence of anxious depression among Taiwanese outpatients diagnosed with MDD was lower compared to inpatients but substantially higher than the reported rates in European countries and the United States. Furthermore, patients with anxious depression exhibited a greater occurrence of somatic symptoms.
참고문헌 (35)
- Gorman JM, "Comorbid depression and anxiety spectrum disorders", Depress Anxiety, 4, pp.160~168 (1996)
- Hirschfeld RM, "The comorbidity of major depression and anxiety dis orders : recognition and management in primary care", Prim Care Companion J Clin Psychiatry, 3, pp.244~254 (2001)
- Kessler RC, "Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys", Epi demiol Psychiatr Sci, 24, pp.210~226 (2015)
- Tundo A, "Is there a relationship between depression with anxious distress DSM-5 specifier and bipolarity? A multicenter cohort study on patients with unipolar, bipolar I and II disorders", J Affect Disord, 245, pp.819826~ (2019)
- Ziebold C, "Diagnostic consequences of a new category of anxious depression and a reduced duration requirement for anxiety symptoms in the ICD-11PHC", J Affect Disord, 245, pp.120~125 (2019)
- Gaspersz R, "Patients with anx ious depression : overview of prevalence, pathophysiology and impact on course and treatment outcome", Curr Opin Psychiatry, 31, pp.17~25 (2018)
- Ionescu DF, "Pharmacologic treatment of dimensional anxious depression: a review", Prim Care Companion CNS Disord, 16, pp.PCC.13r01621~ (2014)
- Fava M, "Difference in treatment outcome in outpatients with anxious versus nonanxious depression : a STAR*D report", Am J Psy chiatry, 165, pp.342~351 (2008)
- Lin CH, "A comparison of in patients with anxious depression to those with nonanxious depression", Psychiatry Res, 220, pp.855~860 (2014)
- Wiethoff K, "Prevalence and treatment outcome in anxious versus nonanxious depression : results from the German Algorithm Project", J Clin Psychiatry, 71, pp.1047~1054 (2010)
- Liu W, "Mediating effect of neurocognition between severity of symptoms and social-occupa tional function in anxious depression", J Affect Disord, 246, pp.667673~ (2019)
- First MB, "Comprehensive handbook of psychological assessment, vol. 2. Personality assessment", pp.134~143 (2004), John Wiley & Sons, Inc.
- Hamilton M, "A rating scale for depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)
- Fava M, "Fluoxetine versus sertraline and paroxetine in major depression : toler ability and efficacy in anxious depression", J Affect Disord, 59, pp.119126~ (2000)
- Konstantakopoulos G, "On the dif ferential diagnosis of anxious from nonanxious major depression by means of the Hamilton scales", ScientificWorldJournal, 2013, pp.294516~ (2013)
- Fava M, "What clinical and symptom features and comorbid disorders characterize outpatients with anxious major depressive dis order : a replication and extension", Can J Psychiatry, 51, pp.823~835 (2006)
- Tollefson GD, "Fluoxetine, placebo, and tricyclic antidepressants in major depression with and without anxious features", J Clin Psychiatry, 55, pp.50~59 (1994)
- Hamilton M, "Development of a rating scale for primary depressive ill ness", Br J Soc Clin Psychol, 6, pp.278~296 (1967)
- Müller MJ, "Standardized rater training for the Hamilton Depression Rating Scale(HAMD-17)in psychiatric novices", J Affect Disord, 77, pp.65~69 (2003)
- Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
- Che HH, "Validation of the Chi nese version of the Beck Anxiety Inventory", J Formos Med Assoc, 10, pp.447~454 (2006)
- Wu Z, "Difference in remission in a Chinese population with anxious versus nonanxious treatment-resistant depression : a report of OPERATION study", J Affect Disord, 150, pp.834~839 (2013)
- Choi KW, "Comorbid anxiety and depression : clini cal and conceptual consideration and transdiagnostic treatment", Adv Exp Med Biol, 1191, pp.219~235 (2020)
- Fishell A, "Depression and anxiety in pregnancy", J Popul Ther Clin Pharmacol, 17, pp.e363~e369 (2010)
- Feeney J, "Attachment insecurity, de pression, and the transition to parenthood", Pers Relatsh, 10, pp.475493~ (2003)
- Zarghi A, "A study of relationship between love with depression and anxiety in married individuals", Int Clin Neurosci J, 1, pp.26~30 (2014)
- Bastida-González R, "Marital satisfaction and marital status as a protective factor of depression and anxiety", Rev Argent Clin Psic, 26, pp.95~102 (2017)
- Paĺsson SP, "The incidence of first-onset depression in a population followed from the age of 70 to 85", Psychol Med, 31, pp.1159~1168 (2001)
- Duberstein PR, "Personality and risk for depression in a birth cohort of 70-year-olds followed for 15 years", Psychol Med, 38, pp.663~671 (2008)
- Kennedy N, "Clinical trials in psychiatry. By B. Everitt and S. Wessely. (Pp. 189; £27. 50; ISBN 0-19-852642-3. )Oxford University Press : Ox ford. 2003", Psychol Med, 34, pp.1360~1361 (2004)
- Schneibel R, "Sensitivity to detect change and the correlation of clinical factors with the Hamilton Depression Rating Scale and the Beck Depression Inventory in depressed inpatients", Psychiatry Res, 198, pp.62~67 (2012)
- Furukawa TA, "Translating the BDI and BDI-II into the HAMD and vice versa with equipercentile linking", Epidemiol Psychiatr Sci, 29, pp.e24~ (2019)
- Jylhä P, "The relationship of neuroticism and extraversion to symptoms of anxiety and depression in the general population", Depress Anxiety, 23, pp.281~289 (2006)
- Ma S, "Discrepancies be tween self-rated depression and observed depression severity : the ef fects of personality and dysfunctional attitudes", Gen Hosp Psychiatry, 70, pp.25~30 (2021)
- Jacobs DG, "Practice guideline for the assessment and treatment of patients with suicidal behaviors", Am J Psychiatry, 160(11 Suppl), pp.1~60 (2003)