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Comorbid Anxiety Disorders Effect on MDD Therapy

J Affect Disord; ePub 2018 Aug 25; Vittengl, et al

Non-social comorbid anxiety disorders may reduce the efficacy of acute-phase cognitive therapy (CT) for major depressive disorder (MDD) by diminishing both short- and longer term outcomes relative to depressed patients without comorbid anxiety disorders. This according to a recent study that compared CT outcomes among adults with MDD plus social, other, or no comorbid anxiety disorders. Outpatients with recurrent MDD (n=523, including 87 with social and 110 with other comorbid anxiety disorders) received acute-phase CT. Higher risk responders (n=241 with partial or unstable response) were randomized to 8 months of continuation treatment (CT or clinical management plus medication or pill placebo), followed by 24 months of assessment. Lower risk responders (n=49) were assessed for 32 months without additional research treatment. Depression, anxiety symptoms, and social avoidance were measured repeatedly. Researchers found:

  • Other (non-social), but not social, anxiety disorders predicted elevated depression and anxiety symptoms throughout and after acute-phase CT.
  • Social, but not other, anxiety disorders predicted greater reduction in depressive symptoms during acute-phase CT and elevated social avoidance during and after acute-phase CT.


Vittengl JR, Clark LA, Smits JAJ, Thase ME, Jarrett RB. Do comorbid social and other anxiety disorders predict outcomes during and after cognitive therapy for depression? [Published online ahead of print August 25, 2018]. J Affect Disord. doi:10.1016/j.jad.2018.08.053.