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Major depressive disorder: afternoon and evening diurnal mood variation is common

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Madhukar H Trivedi

Correspondence to: Madhukar H Trivedi, MD, Mood Disorders Program & Clinic, Department of Psychiatry, University of Texas Southwestern Medical Center, Exchange Park Express, American General Tower, 6363 Forest Park Road, Suite 13.354, Dallas, Texas, USA; madhukar.trivedi@utsouthwestern.edu

QUESTION

Question:

How common is diurnal mood variation (DMV) and how do patients with classic DMV (morning worsening) differ from those without it or from those with afternoon or evening worsening?

Population:

3744 outpatients aged 18–75 years with non-psychotic major depressive disorder (score ⩾14 on HAM-D-17) who were also enrolled in the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) study. People with schizophrenia, schizoaffective disorder, bipolar disorder, anorexia nervosa, obsessive compulsive disorder or bulimia nervosa were excluded.

Setting:

Primary and psychiatric care sites in the public and private sectors; time period not stated.

Assessment:

Clinicians used their judgement and the DSM-IV-TR diagnostic checklist to diagnose depression. Participants were assessed at baseline with the Inventory of Depressive Symptomatology-Clinician-rated (IDS-C-30) scale, to determine presence of DMV and when mood is lowest. Only those …

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