The Role of Anger/Hostility in Treatment-Resistant Depression: A Secondary Analysis From the ADAPT-A Study.
Major depressive disorder is often accompanied by elevated levels of anger, hostility, and irritability, which may contribute to worse outcomes. The present study is a secondary analysis examining the role of anger/hostility in the treatment response to low-dose aripiprazole added to antidepressant therapy in 225 patients with major depressive disorder and inadequate response to antidepressant treatment. Repeated-measures model demonstrated no drug-placebo difference in treatment response across levels of anger/hostility. However, within-group analyses showed significantly lower placebo response rates in patients with high anger/hostility and a trend for lower drug response rates in patients with high anger/hostility. Pooled response rates across phases and treatments revealed a lower response rate among patients with high anger/hostility. Depressed patients with high anger/hostility demonstrate greater illness severity and lower depressive treatment response rates than patients with low anger/hostility, suggesting that patients with high anger/hostility may have poorer outcomes in response to adjunctive treatment.
*Depression Clinical and Research Program and †Clinical Trials and Network Institute (CTNI), Massachusetts General Hospital; ‡Department of Biostatistics, Boston University; and §Bipolar Clinic and Research Program, Massachusetts General Hospital, Boston, MA.
Lauren B
LB
Fisher
Maurizio
M
Fava
Gheorghe D
GD
Doros
Jonathan E
JE
Alpert
Michael
M
Henry
Ilana
I
Huz
Marlene P
MP
Freeman
D000328:Adult; D000786:Anger; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000068180:Aripiprazole / Q000008:administration & dosage / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy / Q000209:etiology / Q000523:psychology*; D005260:Female; D006791:Hostility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D000068180:Aripiprazole