However, in the absence of a placebo arm, the onset of efficacy is difficult to define and assess (Thase, 2001). During the study, HAM-A total scores showed a statisti-cally significant improvement and the percentage of patients with concomitant anxiety disorder decreased from 85.71 to 42.86%. As in the study conducted on young patients (Volonteri et al., 2010), elderly showed an anxiety amelioration more slowly than depression, with response latency of about 3 months.The study showed a correlation between the severity of anxiety at last assessment, depression severity and duration of illness. Literature data show that anxiety is related with severity of depression, therapy resis-tance and longer duration of illness (Andreescu et al., 2007). It is notable that comorbidity of anxiety symp-toms predict a limited acute response and increased re-currence in elderly patients with MDD (Karp et al., 2008). Another observation is that during the first months of therapy, the clinician and the patient’s per-ception of the depression severity were similar. In the following months, there is a gradual divergence be-tween the clinicians improvement assessment using the HAM-D21 and the lower subjective perception of efficacy, assessed by the BDI. Our study supports pre-viously published data showing a poor correlation be-tween observer and self-rating scales (Moller, 2000).
However, in the absence of a placebo arm, the onset of efficacy is difficult to define and assess (Thase, 2001). During the study, HAM-A total scores showed a statisti-cally significant improvement and the percentage of patients with concomitant anxiety disorder decreased from 85.71 to 42.86%. As in the study conducted on young patients (Volonteri et al., 2010), elderly showed an anxiety amelioration more slowly than depression, with response latency of about 3 months.The study showed a correlation between the severity of anxiety at last assessment, depression severity and duration of illness. Literature data show that anxiety is related with severity of depression, therapy resis-tance and longer duration of illness (Andreescu et al., 2007). It is notable that comorbidity of anxiety symp-toms predict a limited acute response and increased re-currence in elderly patients with MDD (Karp et al., 2008). Another observation is that during the first months of therapy, the clinician and the patient’s per-ception of the depression severity were similar. In the following months, there is a gradual divergence be-tween the clinicians improvement assessment using the HAM-D21 and the lower subjective perception of efficacy, assessed by the BDI. Our study supports pre-viously published data showing a poor correlation be-tween observer and self-rating scales (Moller, 2000).<br>
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