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Early improvements in anxiety, depression, and anger/hostility symptoms and response to antidepressant treatment

Amy Farabaugh, PhD

Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

Shamsah Sonawalla, MD

Psychiatry Research, Jaslok Hospital and Research Centre, Mumbai, IndiaDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

Daniel P. Johnson, BA

Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

Janet Witte, MD, MPH

Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

George I. Papakostas, MD

Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

Tracie Goodness, BA

Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

Alisabet Clain, MS

Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

Lee Baer, PhD

Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

David Mischoulon, PhD, MD

Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

Maurizio Fava, MD

Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

Rebecca Harley, PhD

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

BACKGROUND: The purpose of this study was to examine whether treatment response to fluoxetine by depressed outpatients was predicted by early improvement on any of 3 subscales (Anxiety, Depression, and Anger/ Hostility) of the Symptom Questionnaire (SQ).

METHODS: We evaluated 169 depressed outpatients (52.6% female) between ages 18 and 65 (mean age, 40.3 ± 10.6 years) meeting DSM-III-R criteria for major depressive disorder (MDD). All patients completed the SQ at baseline (week 0) and at weeks 2, 4, and 8 of treatment with fluoxetine 20 mg/d. We defined treatment response as a ≥50% reduction in score on the 17-item Hamilton Rating Scale for Depression, and early improvement on 3 SQ subscales (Anxiety, Depression, and Anger/Hostility) as a >30% reduction in score by week 2.

RESULTS: The percentage of patients with significant early improvement in anger was significantly greater than the percentage of those with early improvements in anxiety or depression. When early improvement on the Anxiety, Depression, and Anger/Hostility subscales of the SQ were assessed independently by logistic regression, all 3 subscales were predictors of response to treatment.

CONCLUSIONS: Early improvement in anger, anxiety, and depressive symptoms may predict response to antidepressant treatment among outpatients with MDD.

KEYWORDS: major depressive disorder, anxiety, hostility, depression, Symptom Questionnaire

ANNALS OF CLINICAL PSYCHIATRY 2010;22(3):166–171

CORRESPONDENCE: Amy Farabaugh, PhD, Director, Psychotherapy Research, Depression Clinical and Research Program, Massachusetts General Hospital, 50 Staniford Street, Suite 401 Boston, MA 02114 USA, E-MAIL:afarabaugh@partners.org
Annals of Clinical Psychiatry ©2010 Quadrant HealthCom Inc.

 
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