Prevalence and clinical correlates of irritability in major depressive disorder: A preliminary report from the sequenced treatment alternatives to relieve depression study

被引:68
作者
Perlis, RH
Fraguas, R
Fava, M
Trivedi, MH
Luther, JF
Wisniewski, SR
Rush, AJ
机构
[1] Massachusetts Gen Hosp, Boston, MA 02114 USA
[2] Harvard Univ, Sch Med, Boston, MA 02115 USA
[3] Univ Texas, SW Med Ctr, Dallas, TX 75230 USA
[4] Univ Pittsburgh, Epidemiol Data Ctr, Pittsburgh, PA USA
关键词
D O I
10.4088/JCP.v66n0202
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background: Irritability is a common feature of major depressive disorder (MDD), though it is not included in the DSM-IV diagnostic criteria for adult MDD and is not assessed in most standard depression rating scales. Irritability with or without depression has been associated with risk for suicide, violence, and cardiovascular disease. Method: The prevalence of significant levels of irritability was examined among the first 1456 outpatients with nonpsychotic MDD entering the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Sociodemographic and clinical features were compared for participants who did and did not report irritability at least 50% of the time during the week preceding study entry. Results: Of 1456 evaluable subjects, 582 (40%) reported irritability more than half the time. These individuals were more likely than nonirritable subjects to be female, to be younger, to be unemployed, and to report a history of at least I suicide attempt. Functional status and quality of life were also poorer in this group. Irritability was correlated with overall depressive severity, which accounted for nearly all of the clinical differences noted, with the exception of vascular disease, for which the association persisted after controlling for age, sex, and depressive severity. Conclusion: Irritability is prevalent among depressed outpatients and associated with a greater likelihood of suicide attempts, poorer functional status, and greater prevalence of vascular disease. It is correlated with overall depression severity and thus may not represent a distinct depressive subtype per se. The impact of irritability on course and treatment outcome merits further study.
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页码:159 / 166
页数:8
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共 106 条
  • [81] ANGER AND HOSTILITY IN DEPRESSION
    RILEY, WT
    TREIBER, FA
    WOODS, MG
    [J]. JOURNAL OF NERVOUS AND MENTAL DISEASE, 1989, 177 (11) : 668 - 674
  • [82] SELF-REPORTED HOSTILITY AND SUICIDAL ACTS, ACCIDENTS, AND ACCIDENTAL DEATHS - A PROSPECTIVE-STUDY OF 21,443 ADULTS AGED 25 TO 59
    ROMANOV, K
    HATAKKA, M
    KESKINEN, E
    LAAKSONEN, H
    KAPRIO, J
    ROSE, RJ
    KOSKENVUO, M
    [J]. PSYCHOSOMATIC MEDICINE, 1994, 56 (04): : 328 - 336
  • [83] Association of anger-related traits with SNPs in the TPH gene
    Rujescu, D
    Giegling, I
    Bondy, B
    Gietl, A
    Zill, P
    Möller, HJ
    [J]. MOLECULAR PSYCHIATRY, 2002, 7 (09) : 1023 - 1029
  • [84] The 16-item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): A psychometric evaluation in patients with chronic major depression
    Rush, AJ
    Trivedi, MH
    Ibrahim, HM
    Carmody, TJ
    Arnow, B
    Klein, DN
    Markowitz, JC
    Ninan, PT
    Kornstein, S
    Manber, R
    Thase, ME
    Kocsis, JH
    Keller, MB
    [J]. BIOLOGICAL PSYCHIATRY, 2003, 54 (05) : 573 - 583
  • [85] Sequenced treatment alternatives to relieve depression (STAR*D): rationale and design
    Rush, AJ
    Fava, M
    Wisniewski, SR
    Lavori, PW
    Trivedi, MH
    Sackeim, HA
    Thase, ME
    Nierenberg, AA
    Quitkin, FM
    Kashner, TM
    Kupfer, DJ
    Rosenbaum, JF
    Alpert, J
    Stewart, JW
    McGrath, PJ
    Biggs, MM
    Shores-Wilson, K
    Lebowitz, BD
    Ritz, L
    Niederehe, G
    [J]. CONTROLLED CLINICAL TRIALS, 2004, 25 (01): : 119 - 142
  • [86] The Inventory of Depressive Symptomatology (IDS): Psychometric properties
    Rush, AJ
    Gullion, CM
    Basco, MR
    Jarrett, RB
    Trivedi, MH
    [J]. PSYCHOLOGICAL MEDICINE, 1996, 26 (03) : 477 - 486
  • [87] SCHLESS AP, 1974, J NERV MENT DIS, V159, P91
  • [88] Emotion traits in older suicide attempters and non-attempters
    Seidlitz, L
    Conwell, Y
    Duberstein, P
    Cox, C
    Denning, D
    [J]. JOURNAL OF AFFECTIVE DISORDERS, 2001, 66 (2-3) : 123 - 131
  • [89] Depression and the risk of coronary heart disease in the normative aging study
    Sesso, HD
    Kawachi, I
    Vokonas, PS
    Sparrow, D
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1998, 82 (07) : 851 - 856
  • [90] Dimensions of anger and CHD in men and women: Self-ratings versus spouse ratings
    Siegman, AW
    Townsend, ST
    Blumenthal, RS
    Sorkin, JD
    Civelek, AC
    [J]. JOURNAL OF BEHAVIORAL MEDICINE, 1998, 21 (04) : 315 - 336