Clin Psychopharmacol Neurosci.  2015 Dec;13(3):263-268. 10.9758/cpn.2015.13.3.263.

Risk Factors for Anxiety in Major Depressive Disorder Patients

  • 1Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), and the Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China. si.tia
  • 2Beijing Huilongguan Hospital, Beijing, China.
  • 3School of Public Health, Peking University Health Science Center, Beijing, China.
  • 4Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.
  • 5Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • 6Shanghai Tongji Hospital, Tongji University Medical School, Shanghai, China.
  • 7Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen, China.
  • 8The First Hospital of Harbin Medical University, Harbin, China.
  • 9Hangzhou Seventh People's Hospital, Hangzhou, China.
  • 10West China Hospital, Sichuan University, Chengdu, China.
  • 11The Affiliated Brain Hospital, Nanjing Medical University, Nanjing, China.
  • 12Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.
  • 13The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
  • 14The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.


To analyze the sociodemographic and clinical factors related to anxiety in patients with major depressive disorder (MDD).
This study involved a secondary analysis of data obtained from the Diagnostic Assessment Service for People with Bipolar Disorders in China (DASP), which was initiated by the Chinese Society of Psychiatry (CSP) and conducted from September 1, 2010 to February 28, 2011. Based on the presence or absence of anxiety-related characteristics, 1,178 MDD patients were classified as suffering from anxious depression (n=915) or non-anxious depression (n=263), respectively.
Compared with the non-anxious group, the anxious-depression group had an older age at onset (t=-4.39, p<0.001), were older (t=-4.69, p<0.001), reported more lifetime depressive episodes (z=-3.24, p=0.001), were more likely to experience seasonal depressive episodes (chi2=6.896, p=0.009) and depressive episodes following stressful life events (chi2=59.350, p<0.001), and were more likely to have a family history of psychiatric disorders (chi2=6.091, p=0.014). Their positive and total scores on the Mood Disorder Questionnaire (MDQ) and the 32-item Hypomania Checklist (HCL-32) (p<0.05) were also lower. The logistic regression analysis indicated that age (odds ratio [OR]=1.03, p<0.001), a lower total MDQ score (OR=0.94, p=0.011), depressive episodes following stressful life events (OR=3.04, p<0.001), and seasonal depressive episodes (OR=1.75, p=0.039) were significantly associated with anxious depression.
These findings indicate that older age, fewer subclinical bipolar features, an increased number of depressive episodes following stressful life events, and seasonal depressive episodes may be risk factors for anxiety-related characteristics in patients with MDD.


Depressive disorder; Anxiety; Risk factors
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