UK researchers have found that depressive and social anxiety symptoms are more severe among tertiary care outpatients with anxiety disorders than among those with unipolar or bipolar depression.

However, the correlation between depressive and social anxiety symptoms in outpatients with anxiety disorders was neglible, the researchers note.

“These findings emphasize the need for comprehensive evaluation and treatment of secondary depression in patients with primary anxiety disorders,” say D Baldwin (University of Southampton) and co-authors.

For their study, the researchers included 75 patients (mean age 46 years) attending a tertiary referral mood and anxiety disorders service, of whom 15 were classified as having bipolar disorder, 35 had unipolar depression, and 19 had anxiety disorders. Depressive symptoms were assessed using the Montgomery??Ӂsberg Depression Rating Scale (MADRS) and social anxiety symptoms by the Liebowitz Social Anxiety Scale (LSAS).

Overall, patients had mean MADRS and LSAS scores of 20.1 and 63.4, respectively, corresponding to moderate intensity depression and anxiety. The authors also found a mean Clinical Global Impression of Severity (CGI-S) score of 3.5, corresponding to mild-to-moderate illness severity.

Patients with anxiety disorders had significantly higher LSAS (78.8 vs 50.0 and 59.4) and CGI-S (3.9 vs 3.1 and 3.3) scores than patients with bipolar or unipolar depression, respectively. LSAS and CGI-S scores were also significantly higher in patients with co-morbid diagnoses (n=37) than in patients with single diagnoses.

Baldwin et al further found a weak correlation between the severity of depressive and social anxiety symptoms in all patients, although both symptoms strongly correlated with overall illness severity.

Furthermore, the strongest correlation between MADRS and LSAS scores was seen in the bipolar group. This correlation was not seen in patients with anxiety disorders.

“The lack of correlation seen in the primary anxiety disorders group is probably explained by the broad range of diagnoses within that group, only 26% of whom had a primary diagnosis of social phobia,” write the authors in the Journal of Affective Disorders.

The team concludes: “Attempts should be made to clarify the determinants of greater social anxiety symptom severity in patients with more severe depressive symptoms.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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