TY - JOUR
T1 - Neurostructural impact of co-occurring anxiety in pediatric patients with major depressive disorder
T2 - A voxel-based morphometry study
AU - Wehry, Anna M.
AU - McNamara, Robert K.
AU - Adler, Caleb M.
AU - Eliassen, James C.
AU - Croarkin, Paul
AU - Cerullo, Michael A.
AU - Delbello, Melissa P.
AU - Strawn, Jeffrey R.
N1 - Publisher Copyright:
© 2014 Elsevier B.V. All rights reserved.
PY - 2015/1/15
Y1 - 2015/1/15
N2 - Background Depressive and anxiety disorders are among the most frequently occurring psychiatric conditions in children and adolescents and commonly present occur together. Co-occurring depression and anxiety is associated with increased functional impairment and suicidality compared to depression alone. Despite this, little is known regarding the neurostructural differences between anxiety disorders and major depressive disorder (MDD). Moreover, the neurophysiologic impact of the presence of anxiety in adolescents with MDD is unknown. Methods Using voxel-based morphometry, gray matter volumes were compared among adolescents with MDD (and no co-morbid anxiety disorders, n=14), adolescents with MDD and co-morbid anxiety ("anxious depression," n=12), and healthy comparison subjects (n=41). Results Patients with anxious depression exhibited decreased gray matter volumes in the dorsolateral prefrontal cortex (DLPFC) compared to patients with MDD alone. Compared to healthy subjects, adolescents with anxious depression had increased gray matter volumes in the pre- and post-central gyri. Limitations The current sample size was small and precluded an analysis of multiple covariates which may influence GMV. Conclusions Gray matter deficits in the DLPFC in youth with anxious depression compared to patients with MDD and no co-occurring anxiety may reflect the more severe psychopathology in these patients. Additionally, the distinct gray matter fingerprints of MDD and anxious depression (compared to healthy subjects) suggest differing neurophysiologic substrates for these conditions, though the etiology and longitudinal trajectory of the differences remain to be determined.
AB - Background Depressive and anxiety disorders are among the most frequently occurring psychiatric conditions in children and adolescents and commonly present occur together. Co-occurring depression and anxiety is associated with increased functional impairment and suicidality compared to depression alone. Despite this, little is known regarding the neurostructural differences between anxiety disorders and major depressive disorder (MDD). Moreover, the neurophysiologic impact of the presence of anxiety in adolescents with MDD is unknown. Methods Using voxel-based morphometry, gray matter volumes were compared among adolescents with MDD (and no co-morbid anxiety disorders, n=14), adolescents with MDD and co-morbid anxiety ("anxious depression," n=12), and healthy comparison subjects (n=41). Results Patients with anxious depression exhibited decreased gray matter volumes in the dorsolateral prefrontal cortex (DLPFC) compared to patients with MDD alone. Compared to healthy subjects, adolescents with anxious depression had increased gray matter volumes in the pre- and post-central gyri. Limitations The current sample size was small and precluded an analysis of multiple covariates which may influence GMV. Conclusions Gray matter deficits in the DLPFC in youth with anxious depression compared to patients with MDD and no co-occurring anxiety may reflect the more severe psychopathology in these patients. Additionally, the distinct gray matter fingerprints of MDD and anxious depression (compared to healthy subjects) suggest differing neurophysiologic substrates for these conditions, though the etiology and longitudinal trajectory of the differences remain to be determined.
KW - Adolescence
KW - Generalized anxiety disorder
KW - Voxel-based morphometry
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U2 - 10.1016/j.jad.2014.09.004
DO - 10.1016/j.jad.2014.09.004
M3 - Article
C2 - 25285899
AN - SCOPUS:84907546209
SN - 0165-0327
VL - 171
SP - 54
EP - 59
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -