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Journal Articles Depression and Anxiety Year : 2013

Irritable mood in adult major depressive disorder: results from the world mental health surveys

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Jordi Alonso
  • Function : Author
Matthias Angermeyer
  • Function : Author
Evelyn Bromet
  • Function : Author
Giovanni de Girolamo
Peter de Jonge
  • Function : Author
Koen Demyttenaere
  • Function : Author
Silvia Florescu
  • Function : Author
Michael Gruber
  • Function : Author
Oye Gureje
Chiyi Hu
  • Function : Author
Yueqin Huang
Elie Karam
  • Function : Author
Robert Jin
  • Function : Author
Jean-Pierre Lépine
  • Function : Author
Daphna Levinson
  • Function : Author
Katie Mclaughlin
  • Function : Author
María Medina-Mora
  • Function : Author
Siobhan O'Neill
  • Function : Author
Yutaka Ono
  • Function : Author
José Posada-Villa
  • Function : Author
Nancy Sampson
  • Function : Author
Kate Scott
Victoria Shahly
  • Function : Author
Dan Stein
Maria Viana
  • Function : Author
Zahari Zarkov
  • Function : Author
Ronald Kessler

Abstract

Background: Although irritability is a core symptom of DSM-IV major depressive disorder (MDD) for youth but not adults, clinical studies find comparable rates of irritability between nonbipolar depressed adults and youth. Including irritability as a core symptom of adult MDD would allow detection of depression-equivalent syndromes with primary irritability hypothesized to be more common among males than females. We carried out a preliminary examination of this issue using cross-national community-based survey data from 21 countries in the World Mental Health (WMH) Surveys (n = 110,729). Methods: The assessment of MDD in the WHO Composite International Diagnostic Interview includes one question about persistent irritability. We examined two expansions of the definition of MDD involving this question: (1) cases with dysphoria and/or anhedonia and exactly four of nine Criterion A symptoms plus irritability; and (2) cases with two or more weeks of irritability plus four or more other Criterion A MDD symptoms in the absence of dysphoria or anhedonia. Results: Adding irritability as a tenth Criterion A symptom increased lifetime prevalence by 0.4% (from 11.2 to 11.6%). Adding episodes of persistent irritability increased prevalence by an additional 0.2%. Proportional prevalence increases were significantly higher, but nonetheless small, among males compared to females. Rates of severe role impairment were significantly lower among respondents with this irritable depression who did not meet conventional DSM-IV criteria than those with DSM-IV MDD. Conclusion: Although limited by the superficial assessment in this single question on irritability, results do not support expanding adult MDD criteria to include irritable mood.

Dates and versions

hal-03118724 , version 1 (22-01-2021)

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Viviane Kovess-Masféty, Jordi Alonso, Matthias Angermeyer, Evelyn Bromet, Giovanni de Girolamo, et al.. Irritable mood in adult major depressive disorder: results from the world mental health surveys. Depression and Anxiety, 2013, 30 (4), pp.395-406. ⟨10.1002/da.22033⟩. ⟨hal-03118724⟩

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