title: The prevalence and clinical characteristics associated with Diagnostic and Statistical Manual Version-5-defined anxious distress specifier in adults with major depressive disorder: results from the International Mood Disorders Collaborative Project.
abstract: OBJECTIVE
  The aim of the study was to evaluate the prevalence of and illness characteristics in adults with major depressive disorder (MDD) with anxious distress specifier (ADS) enrolled in the International Mood Disorders Collaborative Project, which is a collaborative research platform at the Mood Disorders Psychopharmacology Unit, University of Toronto, Canada and the Cleveland Clinic, Cleveland, Ohio, USA.
  
  
  METHODS
  Data from participants who met criteria for a current major depressive episode as part of MDD (n = 830) were included in this post hoc analysis. Diagnostic and Statistical Manual Version-5-defined ADS was operationalized as the presence of at least two out of three proxy items instead of two out of five specifiers.
  
  
  RESULTS
  A total of 464 individuals (i.e. 56%) met criteria for ADS. There were no between-group differences in sociodemographic variables (e.g. gender, employment, marital status). Greater severity of illness was observed in adults with ADS as evidenced by a higher number of hospitalizations, higher rates of suicidal ideation, greater depressive symptom severity, greater workplace impairment, decreased quality of life, and greater self-reported cognitive impairment.
  
  
  CONCLUSIONS
  Our findings underscore the importance of evaluating ADS in adults with MDD as its presence identifies a subpopulation with greater illness-associated burden and hazards.
authors.affiliation: Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada.
authors.forename: Roger S
authors.initials: RS
authors.lastname: McIntyre
authors.affiliation: Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
authors.forename: Hanna O
authors.initials: HO
authors.lastname: Woldeyohannes
authors.affiliation: Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada, and Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
authors.forename: Joanna K
authors.initials: JK
authors.lastname: Soczynska
authors.affiliation: Department of Psychiatry, Psychiatric Center, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Maj
authors.initials: M
authors.lastname: Vinberg
authors.affiliation: Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada, and Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
authors.forename: Danielle S
authors.initials: DS
authors.lastname: Cha
authors.affiliation: Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
authors.forename: Yena
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Gallaugher
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Roman S
authors.initials: RS
authors.lastname: Dale
authors.affiliation: Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
authors.forename: Mohammad T
authors.initials: MT
authors.lastname: Alsuwaidan
authors.affiliation: Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
authors.forename: Rodrigo B
authors.initials: RB
authors.lastname: Mansur
authors.affiliation: Medco Health Solutions, Inc., Fort Worth, TX, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Muzina
authors.affiliation: Translational Psychiatry Research Group and Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Brazil.
authors.forename: Andre
authors.initials: A
authors.lastname: Carvalho
authors.affiliation: Department of Psychiatry, University of Toronto, Toronto, ON, Canada, and Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
authors.forename: Sidney
authors.initials: S
authors.lastname: Kennedy
keywords: Diagnostic and Statistical Manual Version-5; anxious distress specifier; major depressive disorder