title: Should an assessment of Axis I comorbidity be included in the initial diagnostic assessment of mood disorders? Role of QIDS-16-SR total score in predicting number of Axis I comorbidity.
abstract: BACKGROUND
  Axis I comorbidity in mood disorders was common in epidemiological studies. This study was designed to investigate the prevalence, pattern, and number of Axis I comorbidities and the role of the Quick Inventory of Depression Symptomatology - 16 items-Self-Report (QIDS-16-SR) in predicting the number of comorbidities in major depressive disorder (MDD) or bipolar disorder (BPD).
  
  
  METHODS
  Baseline data from the first 300 routine clinical outpatients diagnosed with the Mini International Neuropsychiatric Interview Systematic-Treatment-Enhancement - Program for BPD version 5.0.0 were used. Baseline severity was measured with QIDS-16-SR and Clinical Global Impression-Severity (CGI-S).
  
  
  RESULTS
  Of 113 patients with MDD and 166 with BPD, the prevalence of any current anxiety disorder (AD), substance use disorder (SUD), and attention deficit hyperactivity disorder (ADHD) was 76% versus 74%, 14% versus 29%, and 8% versus 21%, respectively. The most common patterns of current comorbidity were MDD+AD (58.4%) for MDD, and BPD+AD (39.8%) and BPD+AD+SUD (11.4%) for BPD. More than 80% patients with MDD or BPD had ≥ 1 current comorbid disorder. About 20% patients with BPD and 10% with MDD had ≥ 4 other disorders. The number of comorbidities was positively associated with baseline severity and suicidal ideation in both MDD and BPD. A QIDS-16-SR of 10 had a positive predictive value of ≥ 90% in predicting ≥ 1 comorbidity in MDD and BPD.
  
  
  CONCLUSIONS
  The sample was modest and from a tertiary medical center.
  
  
  CONCLUSIONS
  A thorough diagnostic assessment for Axis I comorbidity should be included in all patients with mood disorders, especially when a QIDS-16-SR of ≥ 10 points.
authors.affiliation: Mood and Anxiety Clinic in the Mood Disorders Program of Department of Psychiatry, Case Western Reserve University School of Medicine/University Hospitals Case Medical Center, 10524 Euclid Avenue, 12th Floor, Cleveland, OH 44016, USA. keming.gao@uhhospitals.org
authors.forename: Keming
authors.initials: K
authors.lastname: Gao
authors.forename: Zuowei
authors.initials: Z
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.forename: David E
authors.initials: DE
authors.lastname: Kemp
authors.forename: Philip K
authors.initials: PK
authors.lastname: Chan
authors.forename: Carla M
authors.initials: CM
authors.lastname: Conroy
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Serrano
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ganocy
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Calabrese
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D015995:Prevalence; D057566:Self Report; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology