The clinical correlates of comorbid anxiety symptoms and syndromal anxiety in patients with major depressive disorder

Abstract

This study explored the magnitude and clinical correlates of anxiety in three groups of patients with major depressive disorder (MDD): those with comorbid anxiety disorders (the COM group), those with subthreshold core anxiety disorder symptoms that are the screening items for anxiety disorders on the MINI (the SUB group), and those with neither anxiety disorders nor subthreshold core anxiety disorder symptoms (the NON group). Anxiety symptomatology of 1052 patients from 8 psychiatric settings in mainland China, who met DSM-IV TR criteria for MDD, was assessed using the MINI. The presence of core anxiety symptoms was determined by patient endorsement of any screening item of panic disorder, agoraphobia, social anxiety disorder, or generalized anxiety disorder. The prevalences of comorbid subthreshold core anxiety symptoms and anxiety disorders were 13% and 28.7%, respectively. The SUB and COM cases showed similar patterns of clinical presentation. Both were more likely than the NON cases to be characterized by younger age, concurrent dysthymia and OCD, suicidal ideation and attempted suicides. These findings highlight the importance of assessing both anxiety symptoms and anxiety disorders in the presence of MDD, and suggest the need for novel assessments capable of addressing different levels of anxiety in depressed patients.