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ISSN: 2167-1044

Journal of Depression and Anxiety
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Research Article

Symptoms of Anxiety and Irritability in Patients with Major Depressive Disorder

T. Michelle Brown1*, Dana B. DiBenedetti1, Natalya Danchenko2, Emmanuelle Weiller3 and Maurizio Fava4

1RTI Health Solutions, Research Triangle Park, NC, USA

2Lundbeck SAS, Cedex, France

3H. Lundbeck A/S, Denmark

4Massachusetts General Hospital, Boston, MA, USA

*Corresponding Author:
T. Michelle Brown
PhD, RTI Health Solutions, 200 Park Offices Drive
Research Triangle Park, NC 27709 USA
Tel: +19195417156
Fax: 19195417222
E-mail: [email protected]

Received date: May 04, 2016; Accepted date: June 15, 2016; Published date: June 18, 2016

Citation: Brown TM, DiBenedetti DB, Danchenko N, Weiller E, Fava M (2016) Symptoms of Anxiety and Irritability in Patients with Major Depressive Disorder. J Depress Anxiety 5:237. doi:10.4172/2167-1044.1000237

Copyright: © 2016 Brown TM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Background: Anxiety and irritability often coexist in patients with major depressive disorder (MDD). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) added criteria for an anxious distress specifier for MDD. This study aimed at understanding the various components of anxiety and irritability, their impact, and relationships among them in MDD; and the association of anxious distress and irritability with treatment response. Methods: Focus groups were conducted with patients with MDD reporting symptoms of anxiety, irritability, agitation, and/or aggression. Clinical study data were pooled from open-label antidepressant treatment (ADT) phases of seven studies in patients with MDD and a history of inadequate response for the current depressive episode to one to three ADTs (N = 5,182). Post hoc criteria using study measures were applied to identify patients with symptoms of anxious distress and irritability. ADT response rates were compared for patients with and without anxious distress and irritability. Results: Symptoms of anxiety and irritability frequently coexisted for the focus group participants who often described symptoms of anxious distress (e.g., nervous, tense, restless, worry, fear, out of control, acting out). In the clinical studies, approximately 50% of patients with inadequate response to ADTs presented with symptoms of anxious distress and irritability. The presence of anxious distress was associated with lower ADT response rates. Conclusions: Various anxiety symptoms, including those comprising anxious distress, are prevalent and meaningful in depression, and frequently associated with irritability. Symptoms of anxious distress are associated with a decreased likelihood of ADT response.


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