TY - JOUR
T1 - Clinical features of depression in outpatients with and without co-occurring general medical conditions in STAR*D
T2 - Confirmatory analysis
AU - Yates, William R.
AU - Mitchell, Jeff
AU - Rush, A. John
AU - Trivedi, Madhukar
AU - Wisniewski, Stephen R.
AU - Warden, Diane
AU - Bryan, Charlene
AU - Fava, Maurizio
AU - Husain, Mustafa M.
AU - Gaynes, Bradley N.
PY - 2007
Y1 - 2007
N2 - Background: Concurrent medical comorbidity influences the accurate diagnosis and treatment of major depressive disorder (MDD). Objective: The objective of this study was to validate previous findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study using a confirmation analysis in a previously unanalyzed cohort. Design: Baseline cross-sectional case-control study of patients enrolling in a prospective randomized multistage treatment study of nonpsychotic MDD. Setting: Fourteen regional U.S. centers representing 18 primary care and 23 psychiatric practices. Participants: 2541 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 general medical comorbidity in this population was 50.0% (95% CI = 48.1% to 52.0%), consistent with findings reported for the first cohort. Concurrent significant medical comorbidity was associated with older age, lower income, unemployment, limited education, and longer duration of index depressive episode. The group with significant medical comorbidity reported higher rates of somatic symptoms, gastrointestinal symptoms, sympathetic arousal, and leaden paralysis. These results were generally consistent between the 2 cohorts from STAR*D. Conclusions: Major depressive disorder with concurrent general medical conditions is associated with a specific sociodemographic profile and pattern of depressive symptoms. This association has implications for diagnosis and clinical care.
AB - Background: Concurrent medical comorbidity influences the accurate diagnosis and treatment of major depressive disorder (MDD). Objective: The objective of this study was to validate previous findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study using a confirmation analysis in a previously unanalyzed cohort. Design: Baseline cross-sectional case-control study of patients enrolling in a prospective randomized multistage treatment study of nonpsychotic MDD. Setting: Fourteen regional U.S. centers representing 18 primary care and 23 psychiatric practices. Participants: 2541 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 general medical comorbidity in this population was 50.0% (95% CI = 48.1% to 52.0%), consistent with findings reported for the first cohort. Concurrent significant medical comorbidity was associated with older age, lower income, unemployment, limited education, and longer duration of index depressive episode. The group with significant medical comorbidity reported higher rates of somatic symptoms, gastrointestinal symptoms, sympathetic arousal, and leaden paralysis. These results were generally consistent between the 2 cohorts from STAR*D. Conclusions: Major depressive disorder with concurrent general medical conditions is associated with a specific sociodemographic profile and pattern of depressive symptoms. This association has implications for diagnosis and clinical care.
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U2 - 10.4088/pcc.v09n0102
DO - 10.4088/pcc.v09n0102
M3 - Article
C2 - 17599162
AN - SCOPUS:33847160888
SN - 1523-5998
VL - 9
SP - 7
EP - 15
JO - Primary Care Companion to the Journal of Clinical Psychiatry
JF - Primary Care Companion to the Journal of Clinical Psychiatry
IS - 1
ER -