TY - JOUR
T1 - The impact of comorbid post-traumatic stress disorder in patients with major depressive disorder on clinical features, pharmacological treatment strategies, and treatment outcomes – Results from a cross-sectional European multicenter study
AU - Dold, Markus
AU - Bartova, Lucie
AU - Kautzky, Alexander
AU - Souery, Daniel
AU - Mendlewicz, Julien
AU - Serretti, Alessandro
AU - Porcelli, Stefano
AU - Zohar, Joseph
AU - Montgomery, Stuart
AU - Kasper, Siegfried
N1 - Publisher Copyright:
© 2017 Elsevier B.V. and ECNP
PY - 2017/7
Y1 - 2017/7
N2 - This international, multicenter, cross-sectional study comprising 1346 adult in- and outpatients with major depressive disorder (MDD) investigated the association between MDD as primary diagnosis and comorbid post-traumatic stress disorder (PTSD). In a cross-sectional data collection process, the presence of comorbid PTSD was determined by the Mini International Neuropsychiatric Interview (MINI) and the patients’ socio-demographic, clinical, psychopharmacological, and response information were obtained. Clinical features between MDD with and without concurrent PTSD were compared using descriptive statistics, analyses of covariance (ANCOVA), and binary logistic regression analyses. 1.49% of the MDD patients suffered from comorbid PTSD. Significantly more MDD + comorbid PTSD patients exhibited atypical features, comorbid anxiety disorders (any comorbid anxiety disorder, panic disorder, agoraphobia, and social phobia), comorbid bulimia nervosa, current suicide risk, and augmentation treatment with low-dose antipsychotic drugs. In the binary logistic regression analyses, the presence of atypical features (odds ratio (OR) = 4.49, 95%CI:1.01–20.12; p≤.05), any comorbid anxiety disorder (OR = 3.89, 95%CI:1.60-9.44; p = .003), comorbid panic disorder (OR = 6.45, 95%CI:2.52–16.51; p = .001), comorbid agoraphobia (OR = 6.51, 95%CI:2.54-16.68; p≤.001), comorbid social phobia (OR = 6.16, 95%CI:1.71–22.17; p≤.001), comorbid bulimia nervosa (OR = 10.39, 95%CI:1.21–88.64; p = .03), current suicide risk (OR = 3.58, 95%CI:1.30–9.91; p = .01), and augmentation with low-potency antipsychotics (OR = 6.66, 95%CI:2.50–17.77; p<.001) were associated with concurrent PTSD in predominant MDD. Major findings of this study were (1.) the much lower prevalence rate of comorbid PTSD in predominant MDD compared to the reverse prevalence rates of concurrent MDD in primary PTSD, (2.) the high association to comorbid anxiety disorders, and (3.) the increased suicide risk due to concurrent PTSD.
AB - This international, multicenter, cross-sectional study comprising 1346 adult in- and outpatients with major depressive disorder (MDD) investigated the association between MDD as primary diagnosis and comorbid post-traumatic stress disorder (PTSD). In a cross-sectional data collection process, the presence of comorbid PTSD was determined by the Mini International Neuropsychiatric Interview (MINI) and the patients’ socio-demographic, clinical, psychopharmacological, and response information were obtained. Clinical features between MDD with and without concurrent PTSD were compared using descriptive statistics, analyses of covariance (ANCOVA), and binary logistic regression analyses. 1.49% of the MDD patients suffered from comorbid PTSD. Significantly more MDD + comorbid PTSD patients exhibited atypical features, comorbid anxiety disorders (any comorbid anxiety disorder, panic disorder, agoraphobia, and social phobia), comorbid bulimia nervosa, current suicide risk, and augmentation treatment with low-dose antipsychotic drugs. In the binary logistic regression analyses, the presence of atypical features (odds ratio (OR) = 4.49, 95%CI:1.01–20.12; p≤.05), any comorbid anxiety disorder (OR = 3.89, 95%CI:1.60-9.44; p = .003), comorbid panic disorder (OR = 6.45, 95%CI:2.52–16.51; p = .001), comorbid agoraphobia (OR = 6.51, 95%CI:2.54-16.68; p≤.001), comorbid social phobia (OR = 6.16, 95%CI:1.71–22.17; p≤.001), comorbid bulimia nervosa (OR = 10.39, 95%CI:1.21–88.64; p = .03), current suicide risk (OR = 3.58, 95%CI:1.30–9.91; p = .01), and augmentation with low-potency antipsychotics (OR = 6.66, 95%CI:2.50–17.77; p<.001) were associated with concurrent PTSD in predominant MDD. Major findings of this study were (1.) the much lower prevalence rate of comorbid PTSD in predominant MDD compared to the reverse prevalence rates of concurrent MDD in primary PTSD, (2.) the high association to comorbid anxiety disorders, and (3.) the increased suicide risk due to concurrent PTSD.
KW - Antidepressants
KW - Antipsychotics
KW - Comorbidities
KW - Major depressive disorder
KW - Post-traumatic stress disorder
KW - Treatment response
UR - http://www.scopus.com/inward/record.url?scp=85019975798&partnerID=8YFLogxK
U2 - 10.1016/j.euroneuro.2017.05.004
DO - 10.1016/j.euroneuro.2017.05.004
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 28579072
AN - SCOPUS:85019975798
SN - 0924-977X
VL - 27
SP - 625
EP - 632
JO - European Neuropsychopharmacology
JF - European Neuropsychopharmacology
IS - 7
ER -