10007198 J Clin Psychiatry / Document Archive

Psychiatrist.com Home    Keyword Search

Close [X]

Search Our Sites

Enter search terms below (keywords, titles, authors, or subjects). Then select a category to search and press the Search button. All words are assumed to be required. To search for an exact phrase, put it in quotes. To exclude a term, precede it with a minus sign (-).

Keyword search:

Choose a category:

Choosing the appropriate category will greatly improve your chances of finding the best match.

All files at our sites: J Clin Psychiatry, Primary Care Companion, CME Institute, and MedFair

Search materials from our journals:

Abstracts from The Journal of Clinical Psychiatry, 1996–present, both regular issues and supplements

PDFs of the full text of The Journal of Clinical Psychiatry, 1996–present, both regular issues and supplements (Net Society Platinum [paid subscribers])

PDFs of the full text of The Primary Care Companion to The Journal of Clinical Psychiatry, 1999–present

Search CME offerings:

CME Institute, including CME from journals , supplements, and Web activities for instant CME credit (Net Society Gold [registered users]); also includes information about our CME program

CME activities from regular issues of The Journal of Clinical Psychiatry (Net Society Gold [registered users])

CME Supplements from The Journal of Clinical Psychiatry (Net Society Gold [registered users])

 

The article you requested is

Predictors of Persistence of Comorbid Generalized Anxiety Disorder Among Veterans With Major Depressive Disorder

J Clin Psychiatry 2011;72(11):1445-1451
10.4088/JCP.10m05981blu
Copyright 2010 Physicians Postgraduate Press, Inc.

To view this item, select one of the options below.

  1. NONSUBSCRIBERS
    1. Purchase this PDF for $30
      If you are not a paid subscriber, you may purchase the PDF.
      (You'll need the free Adobe Acrobat Reader.)
    2. Subscribe
      Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($129) or print + online ($166 individual).
    3. Celebrate JCP's 75th Anniversary with a special online-only subscription price of $75.
  2. PAID SUBSCRIBERS
    1. Activate
      If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
    2. Sign in
      As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
  1. Did you forget your password?

Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send an email

| 54.196.57.4

Objective: A limited number of randomized clinical trials show that efficacious pharmacologic treatments exist for comorbid major depressive disorder (MDD) and generalized anxiety disorder (GAD). The aims of this effectiveness study were to describe the impact of a depression care management intervention on the persistence of comorbid GAD symptoms in a sample of primary care patients with MDD and to identify risk factors for persistent GAD.

Method: Data were collected from April 2003 to September 2005 for the Telemedicine-Enhanced Antidepressant Management (TEAM) study, a multisite, randomized effectiveness trial targeting US Department of Veterans Affairs (VA) primary care patients with depression. Veterans aged 26.59–88.36 years received either the TEAM intervention or usual care in small VA community-based outpatient clinics. The TEAM care management intervention focused on optimizing antidepressant therapy through patient education and activation, symptom monitoring, adherence promotion, and side-effect management. Veterans who screened positive for MDD using the Patient Health Questionnaire-9 (based on DSM-IV criteria) and who met the Mini-International Neuropsychiatric Interview criteria (maintaining consistency with DSM-IV-TR) for comorbid GAD at baseline were selected for the present study (N = 168). The primary outcome was persistence of GAD at 6 months and 12 months. All predictors available in the TEAM study data that were described in the literature to be associated with influencing GAD outcomes were examined.

Results: Persistence of depression was the strongest predictor of persistence of comorbid GAD at both 6 months (OR = 5.75; 95% CI, 2.38–13.86; P < .05) and 12 months (OR = 15.56; 95% CI, 6.10–39.68; P < .05). Although the TEAM intervention significantly reduced depression symptom severity, it was not significantly associated with GAD persistence. Insomnia was a significant protective factor for persistence of GAD at 6 months (OR = 0.66; 95% CI, 0.44–0.99; P < .05).

Conclusions: Early screening for presence of comorbid GAD among those with MDD may be valuable both for further research and for enhancing clinical management of GAD and MDD comorbidity.

J Clin Psychiatry

Submitted: January 14, 2010; accepted April 5, 2010.

Online ahead of print: December 14, 2010 (doi:10.4088/JCP.10m05981blu).

Corresponding author: Dinesh Mittal, MD, 2200 Fort Roots Drive, Bldg 58 (152/NLR), North Little Rock, AR 72114 (Dinesh.Mittal@va.gov).