Effect of comorbid anxiety on treatment response and relapse risk in late-life depression: controlled study.
BACKGROUND
Comorbid anxiety is common in depressive disorders in both middle and late life, and it affects response to antidepressant treatment.


OBJECTIVE
To examine whether anxiety symptoms predict acute and maintenance (2 years) treatment response in late-life depression.


METHODS
Data were drawn from a randomised double-blind study of pharmacotherapy and interpersonal psychotherapy for patients age 70 years and over with major depression. Anxiety symptoms were measured using the Brief Symptom Inventory. Survival analysis tested the effect of pre-treatment anxiety on response and recurrence.


RESULTS
Patients with greater pretreatment anxiety took longer to respond to treatment and had higher rates of recurrence. Actuarial recurrence rates were 29% (pharmacotherapy, lower anxiety), 58% (pharmacotherapy, higher anxiety), 54% (placebo, lower anxiety) and 81% (placebo, higher anxiety).


CONCLUSIONS
Improved identification and management of anxiety in late-life depression are needed to achieve response and stabilise recovery.
Andreescu
Carmen
C
Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Room E 823, Pittsburgh, PA15213, USA. Lenzee@upmc.edu.
Lenze
Eric J
EJ
Dew
Mary Amanda
MA
Begley
Amy E
AE
Mulsant
Benoit H
BH
Dombrovski
Alexandre Y
AY
Pollock
Bruce G
BG
Stack
Jacqueline
J
Miller
Mark D
MD
Reynolds
Charles F
CF
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods; D012008:Recurrence; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors