Symptom-Domain Correlates of Self-Reported Anxious Distress in Outpatients With Major Depressive Disorder

Anxious distress is common in major depressive disorder (MDD), but real-world data are limited on its burden and relationship to depressive symptom domains. This study examined the prevalence and symptom-domain correlates of self-reported anxious distress in MDD outpatients.

This cross-sectional study used routinely collected questionnaire and clinical data from Dokkyo Medical University Hospital. Depressive severity was assessed using the Japanese version of the Quick Inventory of Depressive Symptomatology (QIDS-J). Anxious distress was assessed using five self-rated items aligned with the Clinically Useful Depression Outcome Scale-Anxious Distress (CUDOS-A) and DSM-5 framework. Of 309 respondents, the primary analytic cohort comprised 206 participants with QIDS-J total scores of 6 or higher and complete anxious-distress item data.

A lower anxious-distress threshold (at least two items scored > = 2) was met by 153 participants (74.3%), and a stringent threshold (at least two items scored > = 3) by 85 (41.3%). QIDS-J total score correlated with anxious-distress burden (r = 0.614 for > = 2 count, r = 0.669 for > = 3 count, and r = 0.697 for summed score; all p < 0.001). In forced-entry Poisson models, sad mood, negative self-view, and psychomotor symptoms were associated with anxious-distress burden. Post hoc decomposition suggested that this psychomotor association was driven mainly by psychomotor agitation rather than retardation.

Self-reported anxious distress was common among MDD outpatients and was closely associated with depressive severity and specific symptom domains, supporting further evaluation of anxious distress as a clinically relevant psychopathological dimension in MDD.