Anguish as a Clinical Marker of Depressive Vulnerability: Evidence from Outpatient Populations

Abstract Background This study investigated the relationships between anguish, psychopathological symptoms, and psychiatric diagnoses in outpatient populations. Results One hundred patients (17–77 years; M = 44.5) from general, anxiety, and affective disorder clinics at the University of São Paulo were divided into three groups: no anguish (n = 50), anguish (n = 35), and anguish without clear phenomenological description (n = 15). Standardized measures were applied, including the Brief Symptom Inventory, Defensive Style Questionnaire, Hospital Anxiety and Depression Scale, Hamilton Anxiety Rating Scale, State–Trait Anxiety Inventory, and MINI International Neuropsychiatric Interview. Patients with anguish showed higher BSI somatization scores and elevated HAM-A domains (fears, depressed mood, gastrointestinal and neurovegetative symptoms). Depression was more strongly associated with anguish than anxiety, with depressed patients 3.64 times more likely to report it. Conclusions Anguish represents a clinically meaningful marker of depressive vulnerability, enhancing diagnostic precision and guiding therapeutic interventions.