Depression and comorbid panic in primary care patients

Angela M. DeVeaugh-Geiss, Suzanne L. West, William C. Miller, Betsy Sleath, Kurt Kroenke, Bradley N. Gaynes

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Comorbid panic symptoms may complicate depression treatment. However, most research focuses on specialty care, and the evidence in primary care is mixed. Methods: We analyzed data from a randomized trial investigating Selective Serotonin Reuptake Inhibitor (SSRI) Treatment, a longitudinal effectiveness study comparing 3 SSRIs for the treatment of depression in primary care (n = 573). Depression at month 6 was measured using the Symptom Checklist-20; remission was defined as a score ≤ 0.5; partial response was defined as ≥ 50% improvement but not to a level of ≤ 0.5. Nonresponse, the referent level for all analyses, was defined as patients who do not meet either of these criteria. Panic symptoms (yes/no) were measured using a screening question. Results: Rates of remission vs. nonresponse [OR = 1.06 (95% confidence interval 0.67, 1.67)] or partial response vs. nonresponse [OR = 0.92 (95% CI 0.54, 1.57)] were similar among patients with baseline panic symptoms, adjusting for baseline depression severity. However, patients with persistent panic symptoms were less likely to experience remission (OR = 0.38, 95% CI 0.18, 0.81), while the lower likelihood of partial response did not achieve statistical significance (0.66, 95% CI 0.33, 1.33). Results were similar using complete case, last observation carried forward, and multiple imputation methods, and were robust to varying the sensitivity and specificity of the panic screening question. Conclusion: Panic symptoms that persist are associated with worse depression outcomes in the maintenance phase. Consequently, improvement in panic symptoms may be important for improved depression outcomes and primary care physicians should be attuned to the presence of panic symptoms when making treatment decisions.

Original languageEnglish
Pages (from-to)283-290
Number of pages8
JournalJournal of Affective Disorders
Volume123
Issue number1-3
DOIs
StatePublished - Jun 2010

Fingerprint

Panic
Primary Health Care
Depression
Serotonin Uptake Inhibitors
Primary Care Physicians
Therapeutics
Checklist
Longitudinal Studies
Decision Making
Maintenance
Observation
Confidence Intervals
Sensitivity and Specificity
Research

Keywords

  • Antidepressant
  • Depression
  • Panic
  • Primary care

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

DeVeaugh-Geiss, A. M., West, S. L., Miller, W. C., Sleath, B., Kroenke, K., & Gaynes, B. N. (2010). Depression and comorbid panic in primary care patients. Journal of Affective Disorders, 123(1-3), 283-290. https://doi.org/10.1016/j.jad.2009.09.013

Depression and comorbid panic in primary care patients. / DeVeaugh-Geiss, Angela M.; West, Suzanne L.; Miller, William C.; Sleath, Betsy; Kroenke, Kurt; Gaynes, Bradley N.

In: Journal of Affective Disorders, Vol. 123, No. 1-3, 06.2010, p. 283-290.

Research output: Contribution to journalArticle

DeVeaugh-Geiss, AM, West, SL, Miller, WC, Sleath, B, Kroenke, K & Gaynes, BN 2010, 'Depression and comorbid panic in primary care patients', Journal of Affective Disorders, vol. 123, no. 1-3, pp. 283-290. https://doi.org/10.1016/j.jad.2009.09.013
DeVeaugh-Geiss AM, West SL, Miller WC, Sleath B, Kroenke K, Gaynes BN. Depression and comorbid panic in primary care patients. Journal of Affective Disorders. 2010 Jun;123(1-3):283-290. https://doi.org/10.1016/j.jad.2009.09.013
DeVeaugh-Geiss, Angela M. ; West, Suzanne L. ; Miller, William C. ; Sleath, Betsy ; Kroenke, Kurt ; Gaynes, Bradley N. / Depression and comorbid panic in primary care patients. In: Journal of Affective Disorders. 2010 ; Vol. 123, No. 1-3. pp. 283-290.
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