A new study provides insight into the clinical significance of mixed features in major depressive disorder and their implications for treatment.
The study analyzed data from the Veterans Affairs Augmentation and Switching Treatments for Improving Depression Outcomes (VAST-D) study, a large, multisite randomized clinical trial of patients whose depression had not improved with antidepressant treatment.
The results were published Aug. 12 in the Journal of Psychopharmacology.
Somaia Mohamed, MD, PhD, associate professor of psychiatry at Yale School of Medicine, served as the National Study Primary Chair of the federally funded VAST-D study and is the senior author.
Mixed features—the presence of symptoms associated with mania or hypomania during a major depressive episode—occur in a meaningful proportion of patients with depression and can be associated with a more complicated clinical course. Despite their clinical importance, evidence to guide how mixed features should influence treatment decisions remains limited.
Using the large VAST-D sample, Mohamed and colleagues found that mixed symptoms were common and associated with greater depression severity, functional impairment, and recurrent depressive episodes.
“Mixed features are clinically important, but we still have relatively limited evidence to guide treatment decisions,” Mohamed says. “VAST-D provides an opportunity to examine these questions in a large population of patients treated in real-world clinical settings.”