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Mixed findings were observed for specific comorbid anxiety disorders with respect to treatment response. For instance, a recent naturalistic study across 8 European countries conducted among patients with MDD showed that those with a comorbid GAD showed poorer treatment response to antidepressant medication compared with those with comorbid panic disorder.

A range of studies have observed a distinct neurobiological profile in patients with anxious depression compared with patients with nonanxious depression. Alterations in white blood cell counts suggest altered immune functioning and implicate inflammation as a potential mechanism in anxious depression; dysregulation of the hypothalamic-pituitary-adrenal axis has also been found in such patients.

Other findings have linked anxious depression with more severe cortical thinning in the orbitofrontal and anterior cingulate cortex, insula, and temporal lobes compared with that seen in nonanxious depression. The thyrotropin-releasing hormone test may predict recurrence of clinical depression within ten years after discharge.

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Course and Prognosis of Mood Disorders | eNetMD

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Recurrence of bipolar disorders and major depression. A life-long perspective.

The Clinical Course of Unipolar Major Depressive Disorders

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Lecture 1D: Major Depressive Disorder and Medical Conditions

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