The Role of Anger/Hostility in Treatment-Resistant Depression: A Secondary Analysis From the ADAPT-A Study

J Nerv Ment Dis. 2015 Oct;203(10):762-8. doi: 10.1097/NMD.0000000000000364.

Abstract

Major depressive disorder is often accompanied by elevated levels of anger, hostility, and irritability, which may contribute to worse outcomes. The present study is a secondary analysis examining the role of anger/hostility in the treatment response to low-dose aripiprazole added to antidepressant therapy in 225 patients with major depressive disorder and inadequate response to antidepressant treatment. Repeated-measures model demonstrated no drug-placebo difference in treatment response across levels of anger/hostility. However, within-group analyses showed significantly lower placebo response rates in patients with high anger/hostility and a trend for lower drug response rates in patients with high anger/hostility. Pooled response rates across phases and treatments revealed a lower response rate among patients with high anger/hostility. Depressed patients with high anger/hostility demonstrate greater illness severity and lower depressive treatment response rates than patients with low anger/hostility, suggesting that patients with high anger/hostility may have poorer outcomes in response to adjunctive treatment.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anger*
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / therapeutic use
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use
  • Aripiprazole / administration & dosage
  • Aripiprazole / therapeutic use
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / psychology
  • Depressive Disorder, Treatment-Resistant / drug therapy
  • Depressive Disorder, Treatment-Resistant / etiology
  • Depressive Disorder, Treatment-Resistant / psychology*
  • Female
  • Hostility*
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Surveys and Questionnaires

Substances

  • Antidepressive Agents
  • Antipsychotic Agents
  • Aripiprazole