Symptom‐Domain Correlates of Self‐Reported Anxious Distress in Outpatients With Major Depressive Disorder

Aim Anxious distress is common in major depressive disorder (MDD), but real‐world data are limited on its burden and relationship to depressive symptom domains. This study examined the prevalence and symptom‐domain correlates of self‐reported anxious distress in MDD outpatients. Methods This cross‐sectional study used routinely collected questionnaire and clinical data from Dokkyo Medical University Hospital. Depressive severity was assessed using the Japanese version of the Quick Inventory of Depressive Symptomatology (QIDS‐J). Anxious distress was assessed using five self‐rated items aligned with the Clinically Useful Depression Outcome Scale‐Anxious Distress (CUDOS‐A) and DSM‐5 framework. Of 309 respondents, the primary analytic cohort comprised 206 participants with QIDS‐J total scores of 6 or higher and complete anxious‐distress item data. Results A lower anxious‐distress threshold (at least two items scored > = 2) was met by 153 participants (74.3%), and a stringent threshold (at least two items scored > = 3) by 85 (41.3%). QIDS‐J total score correlated with anxious‐distress burden ( r = 0.614 for > = 2 count, r = 0.669 for > = 3 count, and r = 0.697 for summed score; all p < 0.001). In forced‐entry Poisson models, sad mood, negative self‐view, and psychomotor symptoms were associated with anxious‐distress burden. Post hoc decomposition suggested that this psychomotor association was driven mainly by psychomotor agitation rather than retardation. Conclusion Self‐reported anxious distress was common among MDD outpatients and was closely associated with depressive severity and specific symptom domains, supporting further evaluation of anxious distress as a clinically relevant psychopathological dimension in MDD.