Irritability is associated with anxiety and greater severity, but not bipolar spectrum features, in major depressive disorder

R. H. Perlis, M. Fava, M. H. Trivedi, Jonathan E. Alpert, J. F. Luther, S. R. Wisniewski, A. John Rush

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Objective: Irritability is common during major depressive episodes, but its clinical significance and overlap with symptoms of anxiety or bipolar disorder remains unclear. We examined clinical correlates of irritability in a confirmatory cohort of Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study participants with major depressive disorder (MDD). Method: Logistic regression was used to identify features associated with presence of irritability on the clinician-rated Inventory of Depressive Symptomatology. Results: Of 2307 study participants, 1067(46%) reported irritability at least half the time during the preceding week; they were more likely to be female, to be younger, to experience greater depression severity and anxiety, and to report poorer quality of life, prior suicide attempts and suicidal ideation. Bipolar spectrum features were not more common among those with irritability. Conclusion: Irritable depression is not a distinct subtype of MDD, but irritability is associated with greater overall severity, anxiety comorbidity and suicidality.

Original languageEnglish (US)
Pages (from-to)282-289
Number of pages8
JournalActa Psychiatrica Scandinavica
Volume119
Issue number4
DOIs
StatePublished - Apr 2009
Externally publishedYes

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Major Depressive Disorder
Anxiety
Depression
Suicidal Ideation
Anxiety Disorders
Bipolar Disorder
Suicide
Comorbidity
Logistic Models
Quality of Life
Equipment and Supplies

Keywords

  • Anger
  • Bipolar disorder
  • Diagnosis
  • Irritability
  • Major depressive disorder
  • Suicide

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Irritability is associated with anxiety and greater severity, but not bipolar spectrum features, in major depressive disorder. / Perlis, R. H.; Fava, M.; Trivedi, M. H.; Alpert, Jonathan E.; Luther, J. F.; Wisniewski, S. R.; John Rush, A.

In: Acta Psychiatrica Scandinavica, Vol. 119, No. 4, 04.2009, p. 282-289.

Research output: Contribution to journalArticle

Perlis, R. H. ; Fava, M. ; Trivedi, M. H. ; Alpert, Jonathan E. ; Luther, J. F. ; Wisniewski, S. R. ; John Rush, A. / Irritability is associated with anxiety and greater severity, but not bipolar spectrum features, in major depressive disorder. In: Acta Psychiatrica Scandinavica. 2009 ; Vol. 119, No. 4. pp. 282-289.
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