Comorbid anxiety in late‐life depression: Relationship with remission and suicidal ideation on venlafaxine treatment

Abstract

Objective: The purpose of this study was to examine the influence of comorbid anxiety symptoms on antidepressant treatment remission in older adults with major depressive disorder (MDD). Method: In this multisite clinical trial, 468 older adults aged 60 years or older with MDD received open-label protocolized treatment with venlafaxine extended release (ER) titrated to a maximum of 300 mg daily. At baseline, anxiety was assessed with the Anxiety Sensitivity Index, the Brief Symptom Inventory (BSI) anxiety subscale, and the Penn State Worry Questionnaire. To measure treatment response, depressive symptoms and suicidality were assessed every 1-2 weeks with the Montgomery-Asberg Depression Rating Scale and the 19-item Scale for Suicide Ideation; anxiety was assessed with the BSI. Logistic regression and survival analysis were used to evaluate whether anxiety symptoms predicted depression remission.We also examined the relationships between anxiety scores and suicidality at baseline.Results: Baseline anxiety symptoms did not predict remission or time to remission of depressive symptoms. Depressive, worry, and panic symptoms decreased in parallel in patients with high anxiety. Anxiety symptoms were associated with the severity of depression and with suicidality.Conclusion: In older adults with MDD, comorbid anxiety symptoms are associated with symptom severity but do not affect antidepressant remission or time to remission. K E Y W O R D S antidepressants, anxiety/anxiety disorders, depression, geriatric/aging/elderly, suicide/self-harm Institute of Mental Health (R01 MH083660 and P30 MH90333 to University of Pittsburgh, R01 MH083648 to Washington University, and R01 MH083643 to University of Toronto).

The network of psychosocial health in middle-aged and older adults during the first COVID-19 lockdown

“…People with more neurotic personality traits and vulnerability to hyperarousal might be more likely to worry about the COVID-19 pandemic more, and at the same time feel more anxious about it [ 34 , 35 ]. However, because of the strong association between depression and anxiety, comorbid symptoms are likely to occur over time [ 36 , 37 ].…”

Disruption of the structural and functional connectivity of the frontoparietal network underlies symptomatic anxiety in late-life depression

“…Depression that occurs after 60–65 years of age is typically referred to as late-life depression (LLD), which affects 4–10% of elderly adults [1] , [2] , [3] . Late-life depression is a heterogeneous illness that is characterized by depressed mood, anhedonia, and cognitive problems, especially high rates of psychic and somatic anxiety [4] , [5] . In contrast to depression in the younger population, LLD is frequently associated with aging-related neurodegeneration, cognitive impairment, and somatic complaints.…”

Multiscale neural signatures of major depressive, anxiety, and stress-related disorders

“…The MDD- and MDD + ANX groups showed cortical thickness differences from the control group that were consistent with previous meta-analyses of brain structure in MDD ( 34 , 35 ), with notable thinning of the parietal and prefrontal cortex (insula, anterior cingulate, inferior frontal, superior frontal and middle frontal gyri, and anterior temporal lobe). Comorbid MDD and anxiety are typically associated with greater symptom severity and more limited level of daily functioning ( 39 , 40 ). Consistent with the expectation of greater disorder severity in comorbid MDD and anxiety disorders, we found additional thinning in the medial temporal regions (parahippocampal area), suggesting a more profound impact of the comorbid disorders on brain structure.…”