Anxiety is a common comorbidity among drug-naive individuals with first-episode major depressive disorder, according to cross-sectional study data published in the Journal of Affective Disorders.

Patients were recruited from the psychiatric department of a general hospital in Taiyuan, China. Drug-naive individuals receiving outpatient care and reporting first-episode major depressive disorder were eligible for inclusion. Demographic and clinical data, including past suicide attempt and psychotic symptoms, were assessed during the study visit. The Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale were used to grade depressive and anxiety symptoms, respectively. Regression analyses were performed to identify predictors of comorbid anxiety in this population.

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A total of 1718 patients were recruited, among whom 1130 (65.8%) were women. The mean age of participants was 34.87±12.43 years. Patients reported a mean depressive episode duration of 6.31±4.73 months, with a range of 5 to 28 months. Anxiety symptoms were observed in 80.3% of the general sample, with 67.6% and 12.7% of the total cohort experiencing mild to moderate and moderate to severe symptoms, respectively.

Compared with patients without anxiety, patients with anxiety were more likely to report prior suicide attempt (24.3% vs 3.3%) and psychotic symptoms (12.3% vs 0.3%; both P <.001). Patients with anxiety also had higher mean Hamilton Depression Rating Scale scores (30.84±2.81 vs 28.08±2.35; P <.001) than patients without anxiety. Regression analysis identified history of suicide attempt and psychotic symptoms as independent risk factors for anxiety. Specifically, patients with prior suicide attempt had 42-fold increased odds of anxiety compared with patients without a history of suicide attempt (odds ratio, 42.1; 95% CI, 4.16-14.30). Similarly, patients with comorbid psychotic symptoms (odds ratio, 11.78; 95% CI, 4.40-228.19) were significantly more likely to have anxiety than their counterparts without psychotic symptoms.

The study group comprised Chinese participants; as such, results should be cautiously extended to other populations.

In a cohort of drug-naive patients with first-episode major depressive disorder, anxiety was a prevalent comorbidity. Patients with prior suicide attempt and comorbid psychotic symptoms were at increased risk for anxiety.

“[O]ur findings have important implications for clinical practice, because the understanding and treatment of anxious symptoms in early acute phase of MDD may lead to better outcomes,” the researchers concluded.

Reference

Yang W, Zhang G, Jia Q, et al. Prevalence and clinical profiles of comorbid anxiety in first episode and drug naïve patients with major depressive disorder. J Affect Disord. 2019;257:200-206.