Department of Psychiatry, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Department of Psychiatry, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan.
Int J Psychiatry Clin Pract. 2021 Nov;25(4):385-392. doi: 10.1080/13651501.2021.1907415. Epub 2021 Apr 11.
Anxious distress (ANXD), which is common in major depressive disorder (MDD), is associated with poor outcomes. We investigated clinical characteristics of MDD patients with the DSM-5 ANXD specifier and only mild residual symptoms without comorbid anxiety disorders in the continuation/maintenance phase.
We recruited 110 outpatients with MDD without comorbid anxiety disorders. They were interviewed; the presence of the DSM-5 ANXD specifier was assessed. They completed the Quick Inventory of Depressive Symptomatology (QIDS), the Eysenck Personality Questionnaire (S-EPQ), the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A).
The mean QIDS total score was 9.7 ± 5.5. The DSM-5 ANXD specifier was identified in 73 patients (66.4%). A univariate analysis indicated ANXD was significantly associated with younger age; unmarried status; living alone; higher QIDS total score; higher S-EPQ neuroticism score; and higher TEMPS-A cyclothymic, depressive and irritable scores. After covariate adjustment, a multivariable linear regression analysis revealed a significant association between the QIDS total score and ANXD (three different models).
The DSM-5 ANXD was also common among MDD patients without comorbid anxiety disorders in the continuation/maintenance phase; it was significantly associated with greater depression severity and might be related to temperament associated with bipolar disorder.Key pointsDSM-5 anxious distress is common among MDD patients without comorbid anxiety disorders in the continuation/maintenance phase and correlated with some of their socio-demographic and clinical characteristics. • The presence of DSM-5 anxious distress was significantly associated with greater severity of depression and might be related to temperament associated with bipolar disorder.• The evaluation of the DSM-5 anxiety distress was revealed to have some significance not only in the acute phase but also in the continuation/maintenance phase of MDD.
焦虑困扰（ANXD）在重度抑郁症（MDD）中很常见，与不良结局相关。我们在 MDD 患者的延续/维持阶段，研究了符合 DSM-5 ANXD 特征且仅存在轻度残留症状而无共病焦虑障碍的患者的临床特征。
我们招募了 110 名无共病焦虑障碍的 MDD 门诊患者。对他们进行访谈；评估 DSM-5 ANXD 特征的存在情况。他们完成了抑郁症状快速清单（QIDS）、艾森克人格问卷（S-EPQ）、孟菲斯、比萨、巴黎和圣地亚哥自动问卷的脾气评估（TEMPS-A）。
平均 QIDS 总分 9.7±5.5。73 名患者（66.4%）符合 DSM-5 ANXD 特征。单因素分析表明，ANXD 与年龄较小、未婚、独居、QIDS 总分较高、S-EPQ 神经质得分较高、TEMPS-A 环性、抑郁和易怒得分较高显著相关。在调整协变量后，多变量线性回归分析显示 QIDS 总分与 ANXD 之间存在显著关联（三种不同模型）。
DSM-5 ANXD 在无共病焦虑障碍的 MDD 患者延续/维持阶段也很常见；与抑郁严重程度显著相关，可能与双相障碍相关的气质有关。关键点：DSM-5 焦虑困扰在无共病焦虑障碍的 MDD 患者延续/维持阶段很常见，与他们的一些社会人口学和临床特征相关。 • DSM-5 焦虑困扰的存在与抑郁严重程度显著相关，可能与双相障碍相关的气质有关。• DSM-5 焦虑困扰的评估不仅在 MDD 的急性期，而且在延续/维持阶段都具有一定的意义。
