Clinical features of depressed outpatients with and without co-occurring general medical conditions in STAR*D.

Journal Article (Clinical Trial;Journal Article;Multicenter Study)

BACKGROUND: A significant percentage of patients with major depressive disorder (MDD) suffer from concurrent general medical conditions (GMCs). OBJECTIVE: The objective of this preliminary report was to describe the rates of co-occurring significant GMCs and the clinical correlates and symptom features associated with the presence of GMCs. DESIGN: Baseline cross-sectional case-control study of patients enrolling in a prospective randomized multistage treatment study of MDD. SETTING: Fourteen regional U.S. centers representing 19 primary care and 22 psychiatric practices. PATIENTS: One thousand five hundred outpatients with DSM-IV nonpsychotic MDD. MEASUREMENTS: Sociodemographic status, medical illness ratings, psychiatric status, quality of life and DSM-IV depression symptom ratings. RESULTS: The prevalence of significant medical comorbidity in this population was 52.8% (95% CI 50.3-55.3%). Concurrent significant medical comorbidity was associated with older age, lower income, unemployment, limited education, longer duration of index depressive episode and absence of self-reported family history of depression. Somatic symptoms common in MDD were endorsed at a higher rate in those with GMCs. Those without a GMC had higher rates of endorsement of impaired mood reactivity, distinct mood quality and interpersonal sensitivity. CONCLUSIONS: Concurrent GMCs are common among outpatients with MDD in both primary care and specialty settings. Concurrent GMCs appear to influence the severity and symptom patterns in MDD and describe a vulnerable population with sociodemographic challenges to effective assessment and treatment.

Full Text

Duke Authors

Cited Authors

  • Yates, WR; Mitchell, J; Rush, AJ; Trivedi, MH; Wisniewski, SR; Warden, D; Hauger, RB; Fava, M; Gaynes, BN; Husain, MM; Bryan, C

Published Date

  • November 2004

Published In

Volume / Issue

  • 26 / 6

Start / End Page

  • 421 - 429

PubMed ID

  • 15567207

International Standard Serial Number (ISSN)

  • 0163-8343

Digital Object Identifier (DOI)

  • 10.1016/j.genhosppsych.2004.06.008

Language

  • eng

Conference Location

  • United States