One year outcome of patients with comorbid depression and anxiety disorders

Abstract

Objective To observe one year outcome of patients with depression comorbidity with anxiety disorders and predictor factors to recurrence. Method Totally 594 patients from 17 hospitals,met with the diagnosis criteria of DSM-Ⅳfor depression,were prospectively evaluated using the 17-item Hamilton Rating Scale for Depression (HAMD17) and Hamilton Rating Scale for Anxiety (HAMA) at the end of 3,6 and 12 months since they were enrolled the study.The conditions of remission,relapse,suicide idea,compliance with medicine and combined therapy were compared between depression comorbidity with (344 cases) or without (250 cases) anxiety disorder.Logistic regression analysis was performed to investigate the recurrent predictors of depression. Results There were 482,441 and 301 patients at the three following points separately.The rate of remission in 3 month was significantly lower in comorbidity group (CG) than that in without comorbidity group (WCG)(53.7% vs.68.0%,P=0.002).The scores of HAMD[(8.80±6.49),(6.86±7.07)]and HAMA[(6.35±4.64),(4.88±4.63)]both were significantly higher in CG than those[HAMD: (7.20±5.97),(5.33±5.86),HAMA: (4.77±4.26),(3.38±3.69) ]in WCG.And only HAMA score (3.98±4.01) in CG was marked higher than that (2.97±3.95) in WCG (P 0.05).But the Kaplan-Meier survival analysis showed the higher recurrent rate in CG (χ2=4.487,P 0.05).About half of patients (50.5% in CG and 43.4% in WCG) were still using benzodiazepines after one year.Logistic regressive analysis showed that suicide idea and compliance with medicine in 6 month point were associated with one year recurrencein this study. Conclusions The results indicate that short outcome in CG is less than WCG,higher recurrent rate also in CG,and supporting the views outside.The one year outcome may be similar in two groups,nearly 4/5 patients obtained remission after they are treated with antidepressants.It should be concerned that about half of patients still take benzodiazepine for long time.The suicide idea is the predictor factor and the compliance with medicine is the protector factor to the recurrence of depression. Key words: Depressive disorder; Anxiety; Comorbidity; Recurrence; Follow-up studies