Table 5. Associations Between MDD Specifiers, Clinical Correlates, Treatment, and Impaired Functioning in 7432 Participants With Lifetime MDDa.
| Characteristic | Anxious/Distressed Specifierb | Mixed-Features Specifierc | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| No (n = 1901) | Yes (n = 5531) | P Value | No (n = 6235) | Yes (n = 1197) | P Value | |||||
| Model 1d | Model 2e | Model 3f | Model 1d | Model 2e | Model 3f | |||||
| Age at onset of first episode, mean (SE), y | 31.16 (0.35) | 28.34 (0.23) | <.001 | <.001 | <.001 | 29.60 (0.22) | 26.11 (0.47) | <.001 | .009 | .17 |
| No. of lifetime episodes, mean (SE) | 2.70 (0.12) | 4.26 (0.13) | <.001 | <.001 | <.001 | 3.69 (0.12) | 4.81 (0.36) | .006 | .009 | .09 |
| Duration of longest or only lifetime episode, median (SE), wk | 22.60 (1.19) | 33.43 (2.99) | .001 | .002 | .08 | 25.70 (0.12) | 51.41 (0.39) | .002 | <.001 | <.001 |
| DSM-5 Specifiers, % (SE) | ||||||||||
| Severitya | ||||||||||
| Mild (5 symptoms) | 23.53 (1.17) | 6.48 (0.41) | <.001 | <.001 | NA | 12.06 (0.47) | 3.93 (0.55) | <.001 | <.001 | NA |
| Moderate (6-7 symptoms) | 53.53 (1.25) | 34.96 (0.87) | 42.12 (0.80) | 26.32 (1.55) | ||||||
| Severe (8-9 symptoms) | 22.95 (1.16) | 58.57 (0.90) | 45.82 (0.74) | 69.75 (1.61) | ||||||
| Anxious/distressed specifiera | NA | NA | NA | NA | NA | 71.29 (0.72) | 92.83 (0.84) | <.001 | <.001 | <.001 |
| Mixed-features specifierb | 4.39 (0.47) | 19.32 (0.85) | <.001 | <.001 | <.001 | NA | NA | NA | NA | NA |
| Lifetime Treatment | ||||||||||
| Any treatment for MDD, % (SE) | 61.06 (1.40) | 72.27 (0.84) | <.001 | <.001 | <.001 | 68.82 (0.79) | 72.72 (1.83) | .05 | <.001 | .02 |
| Medication | 42.26 (1.40) | 56.80 (0.88) | <.001 | <.001 | <.001 | 52.52 (0.85) | 56.33 (1.92) | .06 | <.001 | .05 |
| Talk therapy with a professional | 54.79 (1.49) | 65.11 (0.92) | <.001 | <.001 | <.001 | 61.99 (0.89) | 65.22 (1.73) | .10 | <.001 | .02 |
| Nonprofessional organized support | 9.87 (0.83) | 16.65 (0.65) | <.001 | <.001 | <.001 | 13.48 (0.55) | 22.83 (1.52) | <.001 | <.001 | <.001 |
| Emergency department | 5.06 (0.61) | 11.88 (0.62) | <.001 | <.001 | <.001 | 9.07 (0.46) | 16.02 (1.38) | <.001 | <.001 | .001 |
| Hospitalized overnight or longer | 6.23 (0.63) | 13.75 (0.58) | <.001 | <.001 | <.001 | 10.60 (0.49) | 18.60 (1.41) | <.001 | <.001 | <.001 |
| Age at first MDD treatment, mean (SE), y | 33.74 (0.48) | 31.46 (0.34) | <.001 | <.001 | .008 | 32.56 (0.29) | 29.02 (0.62) | <.001 | .04 | .17 |
| Duration from onset to first treatment, mean (SE), mo | 41.36 (3.83) | 49.37 (1.73) | .06 | .09 | .31 | 46.27 (1.83) | 54.02 (4.28) | .11 | .04 | .07 |
| Suicidality, % (SE)a | ||||||||||
| Thought a lot about one’s own death | 19.97 (1.14) | 39.82 (0.87) | <.001 | <.001 | <.001 | 31.55 (0.80) | 52.36 (1.58) | <.001 | <.001 | <.001 |
| Wanted to die | 31.39 (1.45) | 51.95 (1.08) | <.001 | <.001 | .07 | 43.82 (0.91) | 62.59 (1.76) | <.001 | <.001 | <.001 |
| Thought a lot about suicide | 25.90 (1.23) | 43.87 (0.96) | <.001 | <.001 | .02 | 36.85 (0.83) | 52.68 (1.77) | <.001 | <.001 | .002 |
| Attempted suicide | 6.27 (0.74) | 16.12 (0.70) | <.001 | <.001 | <.001 | 11.97 (0.64) | 22.59 (1.52) | <.001 | <.001 | <.001 |
| SF-12v2 Score, Mean (SE) | ||||||||||
| Mental health | 49.14 (0.31) | 45.58 (0.19) | <.001 | <.001 | <.001 | 46.93 (0.17) | 44.05 (0.45) | <.001 | <.001 | .006 |
| Social functioning | 49.55 (0.31) | 45.82 (0.20) | <.001 | <.001 | <.001 | 47.39 (0.19) | 43.41 (0.42) | <.001 | <.001 | <.001 |
| Role-emotional functioning | 47.72 (0.25) | 44.20 (0.18) | <.001 | <.001 | <.001 | 45.71 (0.18) | 41.73 (0.42) | <.001 | <.001 | <.001 |
| Mental component summary | 48.70 (0.29) | 44.86 (0.17) | <.001 | <.001 | <.001 | 46.40 (0.16) | 42.75 (0.44) | <.001 | <.001 | <.001 |
Abbreviations: MDD, major depressive disorder; NA, not applicable; SF-12v2, version 2 of the 12-Item Short Form Health Survey.
Dichotomous row variables were modeled with logistic regression. Continuous row variables were modeled with linear or log-linear regression.
During the lifetime episode when mood or anhedonia was at its worst.
Mixed features do not meet full criteria for either mania or hypomania and could characterize any MDD episode.
Crude association.
Controls for sociodemographic variables (sex, race/ethnicity, age, marital status, educational level, family income, urbanicity, and region).
Controls for sociodemographic variables (sex, race/ethnicity, age, marital status, educational level, family income, urbanicity, and region) and severity (mild, moderate, or severe).