Characterizing anxiety subtypes and the relationship to behavioral phenotyping in major depression: Results from the EMBARC study.

Autor: Trombello JM; The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA., Pizzagalli DA; Harvard Medical School - McLean Hospital, Department of Psychiatry, Boston, MA, USA., Weissman MM; Columbia University, Department of Psychiatry, New York, NY, USA; New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA., Grannemann BD; The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA., Cooper CM; The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA., Greer TL; The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA., Malchow AL; The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA., Jha MK; The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA., Carmody TJ; The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA., Kurian BT; The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA., Webb CA; Harvard Medical School - McLean Hospital, Department of Psychiatry, Boston, MA, USA., Dillon DG; Harvard Medical School - McLean Hospital, Department of Psychiatry, Boston, MA, USA., McGrath PJ; Columbia University, Department of Psychiatry, New York, NY, USA; New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA., Bruder G; Columbia University, Department of Psychiatry, New York, NY, USA; New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA., Fava M; Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA., Parsey RV; Stony Brook University, Department of Psychiatry, Stony Brook, NY, USA., McInnis MG; University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA., Adams P; New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA., Trivedi MH; The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA. Electronic address: madhukar.trivedi@utsouthwestern.edu.
Jazyk: angličtina
Zdroj: Journal of psychiatric research [J Psychiatr Res] 2018 Jul; Vol. 102, pp. 207-215. Date of Electronic Publication: 2018 Apr 06.
DOI: 10.1016/j.jpsychires.2018.04.003
Abstrakt: The current study aimed to characterize the multifaceted nature of anxiety in patients with major depression by evaluating distinct anxiety factors. We then related these derived anxiety factors to performance on a Flanker Task of cognitive control, in order to further validate these factors. Data were collected from 195 patients with nonpsychotic chronic or recurrent major depression or dysthymic disorder. At baseline, participants completed self-report measures of anxiety, depression, and other related symptoms (mania, suicidality) and clinicians administered a structured diagnostic interview and the Hamilton Rating Scale for Depression, including anxiety/somatization items. Four discrete factors (State Anxiety, Panic, Neuroticism/Worry, and Restlessness/Agitation) emerged, with high degrees of internal consistency. Discriminant and convergent validity analyses also yielded findings in the expected direction. Furthermore, the neuroticism/worry factor was associated with Flanker Task interference, such that individuals higher on neuroticism/worry responded more incorrectly (yet faster) to incongruent vs. congruent trials whereas individuals higher on the fear/panic factor responded more slowly, with no accuracy effect, to the Flanker Task stimuli. These results parse anxiety into four distinct factors that encompass physiological, psychological, and cognitive components of anxiety. While state anxiety, panic and neuroticism/worry are related to existing measures of anxiety, the Restlessness/Agitation factor appears to be a unique measure of general anxious arousal. Furthermore, two factors were independently validated through the Flanker Task. These results suggest that these anxiety domains have distinct behavioral profiles and could have differential responses to distinct treatments.
(Copyright © 2018 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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