Acute and long-term treatment outcome in depressed inpatients with vs. without anxious features: Results of a one-year follow-up study

Background: Anxious depression (AD) is common in patients with unipolar depression, It remains unclear if they have a higher level of depressive symptoms, a higher risk of non-response, a poorer prognosis and a higher relapse rate compared to non-anxious depressed (non-AD) patients. Methods: 168 patients took part in all three measurement points: (1) intake, (2) discharge and (3) follow-up. Patients fulfilled the criteria for anxious depression if they had a baseline score > 7 on the anxiety/somatisation factor of the Hamilton Rating Scale for Depression (HRSD). Patients with AD and non-AD were compared regarding symptom reduction from intake to discharge as well as from discharge to one year after discharge. Primary outcome measure was the HRSD. Results: The prevalence of AD was considerably high (81%). At intake, patients with AD had a significant higher score in the modified HRSD (M=20.67 +/- 4.12 vs. M=14.35 +/- 5.06). Both patient groups showed a significant and comparable intake-to-discharge symptom reduction in all inventories. Remission rates at discharge did not differ between AD and non-AD patients. At 1-year follow-up, AD patients showed a similar symptom severity compared to non-AD patients. Conclusion: Symptoms of anxiety are common in depressive disorders are associated with higher depressive symptoms at the beginning of treatment. Acute and longer-term treatment outcome of AD patients was comparable to that of non-AD patients. Limitations: Limitations of this study are the naturalistic design, treatment was not standardized and comorbid anxiety disorders were not assed using a structured interview. (C) 2013 Elsevier B.V. All rights reserved.