Acute and long-term treatment outcome in depressed inpatients with vs. without anxious features: Results of a one-year follow-up study

Abstract

BackgroundAnxious depression (AD) is common in patients with unipolar depression. It remains unclear if they have a higher level of depressive symptoms, a higher risk of non-response, a poorer prognosis and a higher relapse rate compared to non-anxious depressed (non-AD) patients. Methods168 patients took part in all three measurement points: (1) intake, (2) discharge and (3) follow-up. Patients fulfilled the criteria for anxious depression if they had a baseline score >7 on the anxiety/somatisation factor of the Hamilton Rating Scale for Depression (HRSD). Patients with AD and non-AD were compared regarding symptom reduction from intake to discharge as well as from discharge to one year after discharge. Primary outcome measure was the HRSD. ResultsThe prevalence of AD was considerably high (81%). At intake, patients with AD had a significant higher score in the modified HRSD (M=20.67±4.12 vs. M=14.35±5.06). Both patient groups showed a significant and comparable intake-to-discharge symptom reduction in all inventories. Remission rates at discharge did not differ between AD and non-AD patients. At 1-year follow-up, AD patients showed a similar symptom severity compared to non-AD patients. ConclusionSymptoms of anxiety are common in depressive disorders are associated with higher depressive symptoms at the beginning of treatment. Acute and longer-term treatment outcome of AD patients was comparable to that of non-AD patients. LimitationsLimitations of this study are the naturalistic design, treatment was not standardized and comorbid anxiety disorders were not assed using a structured interview.