Anxious And Non-anxious Depression

Objective:To compare the differences of demographic data,symptoms,neurocognitive function and social-occupational function between patients with anxious and nonanxious depression.And to explore the relationship between severity of symptoms,neurocognitive function and social-occupational function in the two groupsMethods:A cross-sectional survey was conducted in 214 major depressive disorder(MDD)patients.The 17-item Hamilton Depression Rating Scale(HAMD-17)total scores of all patients were?17.Using HAMD-17,the Hamilton Anxiety Rating Scale(HAMA)and its subscales(anxiety/somatization factor,A/S;retardation factor,R;cognitive impairment factor,CD;insomnia factor,SLD;weight factor,W;psychic anxiety factor,PA;somatic anxiety factor,SA)were used to evaluate the severity of symptoms of patients.The four dimensions(speed of processing,SOP;working memory,WM;verbal learning and memory,VBM;visual learning and memory,VSM)of the MATRICS Consensus Cognitive Battery(MCCB)were used to assess the neurocognitive function of patients,and the Global Assessment of Functioning(GAF)was used to assess the social-occupational function of patients.A/S?7 was defined as anxious depression,otherwise nonanxious depression.The differences of demographic data,symptoms,neurocognitive function and social-occupational function between the two groups were compared by using independent sample t-test and rank sum test.Pearson correlation and Spearman correlation were used to analyze the relationship between demographic data,symptoms,neurocognitive function and social-occupational function.Multiple regression was used to determine the determinants of GAF.Finally,PROCESS was used to investigate the mediation model among variablesResults:138 patients(64.5%)were defined as anxious depression,76 patients(35.5%)as nonanxious depression.There were no significant differences in demographic data,neurocognitive function and social-occupational function between the two groups.Anxious depression patients had higher levels of HAMD-17,A/S,HAMA,PA and SA(all p<0.001).In anxious depression patients,GAF was negatively correlated with R and PA(all p<0.010),and positively correlated with VSM(p<0.001).VSM was negatively correlated with R and PA(all p<0.050).In nonanxious depression patients,GAF was only negatively correlated with CD(p<0.010).In anxious group,the first set of multiple regression analysis showed that R,CD and VSM were affecting factors of GAF(R2=0.30,F=20.28,p<0.001).In the second set of multiple regression analysis showed that PA and VSM were affecting factors of GAF(R2=0.10,F=2.37,p=0.011).Only CD was affecting factor of GAF in nonanxious depression patients(R2=0.10,F=9.32,p<0.001).Therefore,there was no mediating model in patients with anxious MDD.While in the nonanxious group,R,VSM and GAF constituted mediating model,in which the total effect of R on GAF was-1.07(t=-3.59,p<0.001),and the indirect effect of R on GAF was-0.24(z=-2.11,p=0.035).The total effect of PA on GAF was-0.67(t=-3.48,p<0.001),and the indirect effect of PA on GAF was-0.15(z=-2.08,p=0.03 8)Conclusion:Most of MDD patients had high level of anxious symptoms.Patients with anxious depression,who had more severe symptoms or worse neurocognition,had worse social-occupational function.Moreover,neurocognion played a positive mediating role between the severity of symptoms and social-occupational function in patients with anxious depression.It means that symptoms,neurocognition and social-occupational function were closely related in patients with anxious depression.