Severity, course trajectory, and within-person variability of individual symptoms in patients with major depressive disorder.
Adult
Biological Variation, Individual
Cognitive Dysfunction
/ diagnosis
Cohort Studies
Depressive Disorder, Major
/ blood
Female
Humans
Male
Medically Unexplained Symptoms
Middle Aged
Mood Disorders
/ diagnosis
Netherlands
/ epidemiology
Outcome Assessment, Health Care
Psychiatric Status Rating Scales
/ standards
Psychometrics
/ methods
Severity of Illness Index
Suicidal Ideation
affective disorders
depression
psychopathology
Journal
Acta psychiatrica Scandinavica
ISSN: 1600-0447
Titre abrégé: Acta Psychiatr Scand
Pays: United States
ID NLM: 0370364
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
accepted:
12
11
2018
pubmed:
18
11
2018
medline:
18
3
2020
entrez:
18
11
2018
Statut:
ppublish
Résumé
Depression shows a large heterogeneity of symptoms between and within persons over time. However, most outcome studies have assessed depression as a single underlying latent construct, using the sum score on psychometric scales as an indicator for severity. This study assesses longitudinal symptom-specific trajectories and within-person variability of major depressive disorder over a 9-year period. Data were derived from the Netherlands Study of Depression and Anxiety (NESDA). This study included 783 participants with a current major depressive disorder at baseline. The Inventory Depressive Symptomatology-Self-Report (IDS-SR) was used to analyze 28 depressive symptoms at up to six time points during the 9-year follow-up. The highest baseline severity scores were found for the items regarding energy and mood states. The core symptoms depressed mood and anhedonia had the most favorable course, whereas sleeping problems and (psycho-)somatic symptoms were more persistent over 9-year follow-up. Within-person variability was highest for symptoms related to energy and lowest for suicidal ideation. The severity, course, and within-person variability differed markedly between depressive symptoms. Our findings strengthen the idea that employing a symptom-focused approach in both clinical care and research is of value.
Sections du résumé
BACKGROUND
Depression shows a large heterogeneity of symptoms between and within persons over time. However, most outcome studies have assessed depression as a single underlying latent construct, using the sum score on psychometric scales as an indicator for severity. This study assesses longitudinal symptom-specific trajectories and within-person variability of major depressive disorder over a 9-year period.
METHODS
Data were derived from the Netherlands Study of Depression and Anxiety (NESDA). This study included 783 participants with a current major depressive disorder at baseline. The Inventory Depressive Symptomatology-Self-Report (IDS-SR) was used to analyze 28 depressive symptoms at up to six time points during the 9-year follow-up.
RESULTS
The highest baseline severity scores were found for the items regarding energy and mood states. The core symptoms depressed mood and anhedonia had the most favorable course, whereas sleeping problems and (psycho-)somatic symptoms were more persistent over 9-year follow-up. Within-person variability was highest for symptoms related to energy and lowest for suicidal ideation.
CONCLUSIONS
The severity, course, and within-person variability differed markedly between depressive symptoms. Our findings strengthen the idea that employing a symptom-focused approach in both clinical care and research is of value.
Identifiants
pubmed: 30447008
doi: 10.1111/acps.12987
pmc: PMC6587785
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
194-205Subventions
Organisme : Netherlands Organization for Health Research and Development
ID : 10-000-1002
Pays : International
Informations de copyright
© 2018 The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.
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