(PS6-A20) Demographic and Clinical Characteristics of Patients with Major Depression and Comorbid Eating Disorders vs Comorbid Anxiety Disorders During a Psychiatric Hospitalization

Major depressive disorder (MDD) is a common form of mental illness characterized by low mood and energy, changes in appetite and psychomotor activity, concentration problems, insomnia, low self-worth, suicidal thinking, and guilt (Baines & Abdijadid, 2022). Previous research has examined the relationships between MDD and other commonly comorbid mental illnesses and has found increased rates of anxiety disorders in those with depression (Ohayon & Schatzberg, 2010; Garcia et al., 2020). Another frequently co-occurring problem found in people with MDD is an eating disorder (ED), which is characterized by the consumption, restriction, and compensation of food that impacts body weight and image (Milos et al., 2013; Sander, Moessner, & Bauer, 2021). This project aims to examine the similarities and differences in clinical presentations between patients with MDD and comorbid ED (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder) vs comorbid anxiety and trauma-related disorders (e.g., social anxiety, generalized anxiety, posttraumatic stress, obsessive-compulsive) to better understand their treatment needs.

Data were extracted from the electronic health records of patients with MDD (N = 1,315) consecutively admitted to the inpatient and partial programs at a psychiatric hospital over a two-year period. Based on chart diagnoses, 435 (33.1%) had MDD without an anxiety or ED, 837 (63.7%) had MDD + anxiety disorder, and 43 (3.3%) with MDD + ED. ANOVA and chi-square tests were used to compare the groups on demographic and clinical characteristics.

Compared with MDD alone, MDD + anxiety disorder had a higher number of axis I disorders (p < .001), were more likely to have a prior hospitalization (p < .001), abuse history (p < .001), and be female (p = < .001), and were less likely to have alcohol use disorder (p < .001), psychosis (p = .020), any drug use disorder (p = .001), or current inpatient admission (p < .001). Compared with MDD alone, MDD + ED had a higher number of axis I (p < .001) and axis II disorders (p = .001), were more likely to have attention-deficit/hyperactivity disorder (p = .005), a current inpatient admission (p = < .001), be female (p < .001) and be younger in age (p < .001), and were less likely to have alcohol use disorder (p = .006). Compared with MDD + anxiety disorder, MDD + ED had a higher number of axis I (p < .001) and axis II disorders (p = .005), were more likely to have attention-deficit/hyperactivity disorder (p = .004), be female (p < .001), and be younger in age (p < .001).

Comorbid conditions often complicate the identification and treatment of MDD. The differing pattern of results we found based on type of comorbid diagnosis show that MDD patients with eating vs anxiety disorders exhibit somewhat unique demographic and clinical characteristics that may be useful in identifying specific problem areas to target for improving patient outcomes.