title: Neurostructural impact of co-occurring anxiety in pediatric patients with major depressive disorder: a voxel-based morphometry study.
abstract: BACKGROUND
  Depressive and anxiety disorders are among the most frequently occurring psychiatric conditions in children and adolescents and commonly present occur together. Co-occurring depression and anxiety is associated with increased functional impairment and suicidality compared to depression alone. Despite this, little is known regarding the neurostructural differences between anxiety disorders and major depressive disorder (MDD). Moreover, the neurophysiologic impact of the presence of anxiety in adolescents with MDD is unknown.
  
  
  METHODS
  Using voxel-based morphometry, gray matter volumes were compared among adolescents with MDD (and no co-morbid anxiety disorders, n=14), adolescents with MDD and co-morbid anxiety ("anxious depression," n=12), and healthy comparison subjects (n=41).
  
  
  RESULTS
  Patients with anxious depression exhibited decreased gray matter volumes in the dorsolateral prefrontal cortex (DLPFC) compared to patients with MDD alone. Compared to healthy subjects, adolescents with anxious depression had increased gray matter volumes in the pre- and post-central gyri.
  
  
  CONCLUSIONS
  The current sample size was small and precluded an analysis of multiple covariates which may influence GMV.
  
  
  CONCLUSIONS
  Gray matter deficits in the DLPFC in youth with anxious depression compared to patients with MDD and no co-occurring anxiety may reflect the more severe psychopathology in these patients. Additionally, the distinct gray matter fingerprints of MDD and anxious depression (compared to healthy subjects) suggest differing neurophysiologic substrates for these conditions, though the etiology and longitudinal trajectory of the differences remain to be determined.
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, 260 Stetson Street, Suite 3200, ML 0559, Cincinnati, OH 45267-0559, USA. Electronic address: wehryam@mail.uc.edu.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Wehry
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, 260 Stetson Street, Suite 3200, ML 0559, Cincinnati, OH 45267-0559, USA.
authors.forename: Robert K
authors.initials: RK
authors.lastname: McNamara
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, 260 Stetson Street, Suite 3200, ML 0559, Cincinnati, OH 45267-0559, USA; Center for Imaging Research, University of Cincinnati, College of Medicine, Cincinnati, OH, USA.
authors.forename: Caleb M
authors.initials: CM
authors.lastname: Adler
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, 260 Stetson Street, Suite 3200, ML 0559, Cincinnati, OH 45267-0559, USA; Center for Imaging Research, University of Cincinnati, College of Medicine, Cincinnati, OH, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Eliassen
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Croarkin
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, 260 Stetson Street, Suite 3200, ML 0559, Cincinnati, OH 45267-0559, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Cerullo
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, 260 Stetson Street, Suite 3200, ML 0559, Cincinnati, OH 45267-0559, USA.
authors.forename: Melissa P
authors.initials: MP
authors.lastname: DelBello
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, 260 Stetson Street, Suite 3200, ML 0559, Cincinnati, OH 45267-0559, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Strawn
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000150:complications* / Q000473:pathology*; D001931:Brain Mapping / Q000379:methods; D002648:Child; D003865:Major Depressive Disorder / Q000150:complications* / Q000473:pathology*; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009929:Organ Size; D010372:Pediatrics / Q000379:methods; D017397:Prefrontal Cortex / Q000473:pathology
keywords: Adolescence; Generalized anxiety disorder; Voxel-based morphometry