The multiple diagnoses of comorbid anxiety disorders and higher interpersonal sensitivity predict treatment-resistant depression

Abstract

The present study was conducted to examine the hypothesis based on our previous studies, that the multiple diagnoses of comorbid anxiety disorders (ADs) and higher interpersonal sensitivity predict treatment-resistant depression (TRD). The participants were 199 consecutive outpatients with major depressive disorder (MDD), who were comprehensively diagnosed using the Mini International Neuropsychiatric Interview (MINI). TRD was defined as the failure to achieve remission with two or more adequate antidepressant trials. Using multiple logistic regression, the clinical features including the number of comorbid ADs and the Interpersonal Sensitivity Measure (IPSM) score of the TRD group (N=31) were compared with those of the remission group (N=123). Comorbid ADs (odds ratio (OR), 4.5), higher IPSM score (OR, 4.1), suicidal risk (OR, 3.9), and non-melancholic features (OR, 3.3) were identified as the most discriminative variables associated with TRD. All the participants with two or more comorbid ADs (N=12) belonged to the TRD group. The results showed that the multiple diagnoses of comorbid ADs and higher interpersonal sensitivity were associated with TRD, suggesting that considering the concept of MDD with "anxious distress," which appears in DSM-5, may be useful for managing TRD.