Depressed Patients' Anxiety Symptoms Often Evade Diagnostic Criteria: Presented at APA

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Depressed Patients' Anxiety Symptoms Often Evade Diagnostic Criteria: Presented at APA

(May 23, 2007) -- SAN DIEGO, CA -- Patients with depression often have comorbid anxiety symptoms that do not meet the criteria of anxiety disorders as defined by the Diagnostic and Statistical Manual – Revision IV (DSM-IV), according to investigators who presented their findings here at the 160th annual meeting of the American Psychiatric Association (APA).

"We wanted to know whether the clinical significance of anxiety disorders in depressed patients extends to depressed patients with anxiety symptoms that do not meet the criteria for a diagnosable anxiety disorder," explained study presenter Jennifer Resch, a student in the department of psychiatry and human behaviour, at Brown University School of Medicine, Providence, Rhode Island, United States.

Ms Resch collaborated in her study with Mark Zimmerman, MD, director of outpatient psychiatry, Rhode Island Hospital in Providence.

The researchers conducted the study to determine whether symptoms of anxiety would predict a worse psychosocial function, even if those symptoms did not meet DSM-IV criteria.

However, the researchers found minimal differences between patients with anxiety scores and those with low anxiety scores.

"Estimates of the prevalence of high anxiety in depressed patients should be based on the presence of a diagnosable disorder and not just symptom levels," Ms. Resch said in her presentation on May 21st.

For their study, the investigators recruited 2,500 psychiatric outpatients, 345 of whom had a diagnosis of nonbipolar major depressive disorder; none of them had a diagnosis of an anxiety disorder as defined by DSM-IV criteria. Subjects underwent a structured clinical interview, and responded to the Medical Outcomes Study Short Form Questionnaire (SF-36) and the Schedule for Affective Disorders and Schizophrenia (SADS).

The investigators defined high anxiety as scores of at least 2 on the SADS items and low anxiety as SADS scores of no more than 1.

Interestingly, the two groups did not differ significantly regarding duration of current depressive episode, number of depressive episodes, or number of prior psychiatric hospitalisations. They also did not differ regarding their rates of substance abuse, alcohol abuse, or suicide attempts.

The two groups had similar psychosocial characteristics as indicated on the SF-36, physicians' global assessments, and rates of missed work over the past 5 years. However, the low anxiety group had a significantly earlier age of onset of major depressive disorder, an average of 28.1 years, while those with high anxiety had an average age of onset of 31.4 years (P =.045).

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The investigators pointed out that the level of anxiety in the high anxiety group was mild to moderate in severity. Therefore, the implications could differ with patients whose anxiety level was severe enough to meet the DSM-IV criteria for a particular anxiety disorder.

By: Pula Moyer
Source: Doctor's Guide

Last updated 05/07

Depressed Patients' Anxiety Symptoms Often Evade Diagnostic Criteria: Presented at APA

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