TY - JOUR
T1 - Comorbid anxiety in late-life depression
T2 - Relationship with remission and suicidal ideation on venlafaxine treatment
AU - Saade, Yasmina M.
AU - Nicol, Ginger
AU - Lenze, Eric J.
AU - Miller, J. Philip
AU - Yingling, Michael
AU - Wetherell, Julie Loebach
AU - Reynolds, Charles F.
AU - Mulsant, Benoit H.
N1 - Funding Information:
We would like to thank Dr. David Dixon and Ms. Julia Schweiger for their help and support which was absolutely critical to this study. This work was supported in part by R25-MH112473 from the NIMH to Washington University's Department of Psychiatry Residency Training Program. This study was supported mainly by the National Institute of Mental Health (R01 MH083660 and P30 MH90333 to University of Pittsburgh, R01 MH083648 to Washington University, and R01 MH083643 to University of Toronto). Additional funding was provided by the UPMC Endowment in Geriatric Psychiatry, the Taylor Family Institute for Innovative Psychiatric Research and Center for Brain Research in Mood Disorders (at Washington University), the Washington University Institute of Clinical and Translational Sciences grant (UL1TR000448) from the National Center for Advancing Translational Sciences, and the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto. P?zer contributed venlafaxine extended-release capsules for this study.
Funding Information:
We would like to thank Dr. David Dixon and Ms. Julia Schweiger for their help and support which was absolutely critical to this study. This work was supported in part by R25‐MH112473 from the NIMH to Washington University's Department of Psychiatry Residency Training Program. This study was supported mainly by the National Institute of Mental Health (R01 MH083660 and P30 MH90333 to University of Pittsburgh, R01 MH083648 to Washington University, and R01 MH083643 to University of Toronto). Additional funding was provided by the UPMC Endowment in Geriatric Psychiatry, the Taylor Family Institute for Innovative Psychiatric Research and Center for Brain Research in Mood Disorders (at Washington University), the Washington University Institute of Clinical and Translational Sciences grant (UL1TR000448) from the National Center for Advancing Translational Sciences, and the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto. Pfizer contributed venlafaxine extended‐release capsules for this study.
Funding Information:
Dr. Ginger Nicol has received research funding from NIMH, Otsuka America, Inc., Alkermes, The Sidney R. Baer, Jr. Foundation, the Center for Brain Research in Mood Disorders (CBRiMD) and the Center for Diabetes Translational Research at Washington University, and serves as a consultant for Alkermes, Sunovion and Supernus Pharmaceuticals, Inc. Dr. Eric Lenze has received research support from NIH, FDA, McKnight Brain Research Foundation, PCORI, Taylor Family Institute for Innovative Psychiatric Research, Center for Brain Research in Mood Disorders, Barnes Jewish Foundation, Aptinyx, Alkermes, Janssen, Takeda, and Lundbeck. Professor J Philipp Miller has received research support from NIH, FDA, and PCORI. Dr. Julie Wetherell has research support from the US National Institutes of Health (NIH). Dr. Charles Reynolds III receives compensation from the American Association for Geriatric Psychiatry as editor of the American Journal of Psychiatry and receives royalty income for intellectual property (the Pittsburgh Sleep Quality Index) as well as occasional honoraria for giving invited lectures and consultation. During the past 5 years, Dr. Benoit Mulsant has received research funding from Brain Canada, the CAMH Foundation, the Canadian Institutes of Health Research, and the US NIH; research support from Bristol‐Myers Squibb (medications for a NIH‐funded clinical trial), Eli‐Lilly (medications for a NIH‐funded clinical trial), Pfizer (medications for a NIH‐funded clinical trial), Capital Solution Design LLC (software used in a study funded by CAMH Foundation), and HAPPYneuron (software used in a study funded by Brain Canada). He directly owns stocks of General Electric (less than $5,000).
Publisher Copyright:
© 2019 Wiley Periodicals, Inc.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Objective: The purpose of this study was to examine the influence of comorbid anxiety symptoms on antidepressant treatment remission in older adults with major depressive disorder (MDD). Method: In this multisite clinical trial, 468 older adults aged 60 years or older with MDD received open-label protocolized treatment with venlafaxine extended release (ER) titrated to a maximum of 300 mg daily. At baseline, anxiety was assessed with the Anxiety Sensitivity Index, the Brief Symptom Inventory (BSI) anxiety subscale, and the Penn State Worry Questionnaire. To measure treatment response, depressive symptoms and suicidality were assessed every 1–2 weeks with the Montgomery–Asberg Depression Rating Scale and the 19-item Scale for Suicide Ideation; anxiety was assessed with the BSI. Logistic regression and survival analysis were used to evaluate whether anxiety symptoms predicted depression remission. We also examined the relationships between anxiety scores and suicidality at baseline. Results: Baseline anxiety symptoms did not predict remission or time to remission of depressive symptoms. Depressive, worry, and panic symptoms decreased in parallel in patients with high anxiety. Anxiety symptoms were associated with the severity of depression and with suicidality. Conclusion: In older adults with MDD, comorbid anxiety symptoms are associated with symptom severity but do not affect antidepressant remission or time to remission.
AB - Objective: The purpose of this study was to examine the influence of comorbid anxiety symptoms on antidepressant treatment remission in older adults with major depressive disorder (MDD). Method: In this multisite clinical trial, 468 older adults aged 60 years or older with MDD received open-label protocolized treatment with venlafaxine extended release (ER) titrated to a maximum of 300 mg daily. At baseline, anxiety was assessed with the Anxiety Sensitivity Index, the Brief Symptom Inventory (BSI) anxiety subscale, and the Penn State Worry Questionnaire. To measure treatment response, depressive symptoms and suicidality were assessed every 1–2 weeks with the Montgomery–Asberg Depression Rating Scale and the 19-item Scale for Suicide Ideation; anxiety was assessed with the BSI. Logistic regression and survival analysis were used to evaluate whether anxiety symptoms predicted depression remission. We also examined the relationships between anxiety scores and suicidality at baseline. Results: Baseline anxiety symptoms did not predict remission or time to remission of depressive symptoms. Depressive, worry, and panic symptoms decreased in parallel in patients with high anxiety. Anxiety symptoms were associated with the severity of depression and with suicidality. Conclusion: In older adults with MDD, comorbid anxiety symptoms are associated with symptom severity but do not affect antidepressant remission or time to remission.
KW - antidepressants
KW - anxiety/anxiety disorders
KW - depression
KW - geriatric/aging/elderly
KW - suicide/self-harm
UR - http://www.scopus.com/inward/record.url?scp=85074748658&partnerID=8YFLogxK
U2 - 10.1002/da.22964
DO - 10.1002/da.22964
M3 - Article
C2 - 31682328
AN - SCOPUS:85074748658
VL - 36
SP - 1125
EP - 1134
JO - Depression and Anxiety
JF - Depression and Anxiety
SN - 1091-4269
IS - 12
ER -