Prevalence and related factors of anxiety in first episode and drug naïve Chinese Han outpatients with psychotic major depression
Yanan Zhou, Qianjin Wang, Honghong Ren, Winson Fu Zun Yang, Yuejiao Ma, Qiuxia Wu, Yinli Luo, Dong Yang, Tieqiao Liu, Xiangyang Zhang
Abstract
BACKGROUND: Anxiety frequently occurs with major depressive disorder (MDD) but to a different extent in the various subtypes. Psychotic major depression (PMD) is a severe subtype of MDD that is under-identified and under-studied. We investigated the prevalence and related risk factors of anxiety in PMD patients. METHODS: A total of 1718 first episode and drug naïve MDD patients were recruited. Measures included the Hamilton Depression Scale (HAMD), Clinical Global Impression-Severity scale (CGI-S), Hamilton Anxiety Scale (HAMA), and positive symptom scale of the Positive and Negative Syndrome Scale (PANSS), thyroid hormone levels, and metabolic parameters. RESULTS: = 294.69, P < 0.001, OR = 75.88, 95 % CI = 31.55-182.52). Compared to PMD patients without severe anxiety, PMD patients with severe anxiety had higher HAMD score, CGI-S score, positive symptom subscale score, suicide attempts, blood pressure, thyroid-stimulating hormone (TSH), anti-thyroglobulin (TgAb), and thyroid peroxidases antibody (TPOAb) levels. Furthermore, logistic regression analysis indicated that HAMD score and TSH levels were associated with severe anxiety in PMD patients. LIMITATIONS: Our cross-sectional study cannot explain the causal relationship between anxiety severity and risk factors in PMD patients. CONCLUSIONS: Our results suggest that PMD patients are more likely to experience severe anxiety than non-PMD patients. The severity of depression and TSH levels are independent risk factors for anxiety in PMD patients.