title: Anxiety does not predict response to antidepressant treatment in late life depression: results of a meta-analysis.
abstract: OBJECTIVE
  Previous studies of mixed aged and older adult samples with major depressive disorder (MDD) reported reduced depression response in anxious patients, but a systematic review and analysis has not been performed. Our aim was to determine if anxiety predicts antidepressant response in previously identified placebo-controlled trials of second generation antidepressants for late-life depression.
  
  
  METHODS
  From a previous systematic review that identified ten randomized, placebo-controlled trials of community dwelling patients aged 60 or older with major depression, anxious patients were identified by a score >or=7 on the anxiety/somatization factor of the Hamilton Depression Rating Scale (HDRS). Response was defined as 50% or greater improvement on the HDRS or the Montgomery Asberg Depression Rating Scale. A meta-analysis was performed using a random effects model to calculate Odds Ratios (OR).
  
  
  RESULTS
  Data were available from eight trials having ten drug-placebo contrasts that included 2322 anxious and 1387 non-anxious patients. The odds ratio for response to drug compared to placebo in anxious patients was 1.57 (95% CI 1.15, 2.14; z = 2.86, n = 10, p < 0.001), in non-anxious patients was 1.44 (95% CI 1.15, 1.80, z = 3.21, n = 10, p < 0.001), and did not differ between groups. Pooled response rates to drug and placebo respectively were 49.4% vs 37.4% in anxious patients and 44.2 vs 35.5% in non-anxious patients.
  
  
  CONCLUSIONS
  In randomized, placebo-controlled trials, anxiety in late-life depression was not associated with decreased response to second generation antidepressants.
authors.affiliation: Department of Psychiatry, University of California San Francisco, CA, USA. craign@lppi.ucsf.edu
authors.forename: J Craig
authors.initials: JC
authors.lastname: Nelson
authors.forename: Kevin
authors.initials: K
authors.lastname: Delucchi
authors.forename: Lon S
authors.initials: LS
authors.lastname: Schneider