Method: Following a one-week, single-blind, wash-out, patients with MDD diagnosed by SCID were randomized to 12 weeks of double-blind treatment with LI 160 St. John’s wort extract (900 mg/day), fluoxetine (20 mg/day), or placebo. The 17-item Hamilton Rating Scale for Depression (HAM-D-17) was the primary efficacy measure. While anxious depression was defined as having a baseline HAM-D anxiety/somatization factor score = or > 7, remission was defined as a HAM-D-17 score = or &lt; 7 at endpoint. The ability of both anxious depression and the individual baseline HAM-D anxiety/somatization factor scores to predict treatment outcome were assessed separately for patients treated with active treatment (St. John’s Wort or fluoxetine) and placebo with a logistic regression method. Results: 135 patients (57% women, mean age: 37.3 ± 11.0; mean HAM-D; 19.7 ± 3.2) were randomized to double-blind treatment and were included in the intent-to-treat analyses, and the remission rates were 38% in the St. John’s wort group, 30% in the fluoxetine group, and 21% in the placebo group. After adjusting for baseline HAM-D-17 scores (minus the anxiety/somatization items), anxious depression had significantly (p < .05) lower remission rates than nonanxious depression with active treatment, but not with placebo. When the six individual items of the HAM-D anxiety/somatization facto were assessed, only psychic and somatic anxiety significantly (p < .05) predicted poorer outcome with active treatment, again after adjusting for baseline HAM-D-17 scores (minus the anxiety/somatization items). Conclusion: The presence of anxious depression and, in particular, of psychic and somatic anxiety, significantly predicted poorer outcome following antidepressant treatment, but such relationship was not present among the placebo-treated patients. Funding Source: Lichtwer 1. Joffe RT, Bagby RM, Levitt A: Anxious and nonanxious depression. Am J Psychiatry 150:1257–1258, 1993. 2. Fava M, Rankin MA, Wright EC, Alpert JE, Nierenberg AA, Pava J, Rosenbaum JF: Anxiety disorders in major depression. Comprehensive Psychiatry 41:97–102, 2000.

Relationship Between Anxious Depression and Treatment Outcome in Outpatients With Depression / E. Tossani; A. Mascarini; J. E. Alpert; D. Mischoulon; G. I. Papakostas; J. L. Ryan; M. Fava. - ELETTRONICO. - (2004). (Intervento presentato al convegno Annual Meeting of the American Psychiatric Association tenutosi a New York, NY nel 01-06 Maggio 2004).

Relationship Between Anxious Depression and Treatment Outcome in Outpatients With Depression

TOSSANI, ELIANA;
2004

Abstract

Method: Following a one-week, single-blind, wash-out, patients with MDD diagnosed by SCID were randomized to 12 weeks of double-blind treatment with LI 160 St. John’s wort extract (900 mg/day), fluoxetine (20 mg/day), or placebo. The 17-item Hamilton Rating Scale for Depression (HAM-D-17) was the primary efficacy measure. While anxious depression was defined as having a baseline HAM-D anxiety/somatization factor score = or > 7, remission was defined as a HAM-D-17 score = or < 7 at endpoint. The ability of both anxious depression and the individual baseline HAM-D anxiety/somatization factor scores to predict treatment outcome were assessed separately for patients treated with active treatment (St. John’s Wort or fluoxetine) and placebo with a logistic regression method. Results: 135 patients (57% women, mean age: 37.3 ± 11.0; mean HAM-D; 19.7 ± 3.2) were randomized to double-blind treatment and were included in the intent-to-treat analyses, and the remission rates were 38% in the St. John’s wort group, 30% in the fluoxetine group, and 21% in the placebo group. After adjusting for baseline HAM-D-17 scores (minus the anxiety/somatization items), anxious depression had significantly (p < .05) lower remission rates than nonanxious depression with active treatment, but not with placebo. When the six individual items of the HAM-D anxiety/somatization facto were assessed, only psychic and somatic anxiety significantly (p < .05) predicted poorer outcome with active treatment, again after adjusting for baseline HAM-D-17 scores (minus the anxiety/somatization items). Conclusion: The presence of anxious depression and, in particular, of psychic and somatic anxiety, significantly predicted poorer outcome following antidepressant treatment, but such relationship was not present among the placebo-treated patients. Funding Source: Lichtwer 1. Joffe RT, Bagby RM, Levitt A: Anxious and nonanxious depression. Am J Psychiatry 150:1257–1258, 1993. 2. Fava M, Rankin MA, Wright EC, Alpert JE, Nierenberg AA, Pava J, Rosenbaum JF: Anxiety disorders in major depression. Comprehensive Psychiatry 41:97–102, 2000.
2004
New Research Abstracts, Annual Meeting of the American Psychiatric Association
Relationship Between Anxious Depression and Treatment Outcome in Outpatients With Depression / E. Tossani; A. Mascarini; J. E. Alpert; D. Mischoulon; G. I. Papakostas; J. L. Ryan; M. Fava. - ELETTRONICO. - (2004). (Intervento presentato al convegno Annual Meeting of the American Psychiatric Association tenutosi a New York, NY nel 01-06 Maggio 2004).
E. Tossani; A. Mascarini; J. E. Alpert; D. Mischoulon; G. I. Papakostas; J. L. Ryan; M. Fava
File in questo prodotto:
Eventuali allegati, non sono esposti

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/27063
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact