Symptom networks in acute depression across bipolar and major depressive disorders: A network analysis on a large, international, observational study.
Bipolar disorder
Cross-disorder
Depression
Mixed features
Network analysis
Journal
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
ISSN: 1873-7862
Titre abrégé: Eur Neuropsychopharmacol
Pays: Netherlands
ID NLM: 9111390
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
25
10
2019
revised:
23
03
2020
accepted:
27
03
2020
pubmed:
16
5
2020
medline:
11
8
2021
entrez:
16
5
2020
Statut:
ppublish
Résumé
Major Depressive Episode (MDE) is a transdiagnostic nosographic construct straddling Major Depressive (MDD) and Bipolar Disorder (BD). Prognostic and treatment implications warrant a differentiation between these two disorders. Network analysis is a novel approach that outlines symptoms interactions in psychopathological networks. We investigated the interplay among depressive and mixed symptoms in acutely depressed MDD/BD patients, using a data-driven approach. We analyzed 7 DSM-IV-TR criteria for MDE and 14 researched-based criteria for mixed features (RBDC) in 2758 acutely depressed MDD/BD patients from the BRIDGE-II-Mix study. The global network was described in terms of symptom thresholds and symptom centrality. Symptom endorsement rates were compared across diagnostic subgroups. Subsequently, MDD/BD differences in symptom-network structure were examined using permutation-based network comparison test. Mixed symptoms were the most central and highly interconnected nodes in the network, particularly agitation followed by irritability. Despite mixed symptoms, appetite gain and hypersomnia were significantly more endorsed in BD patients, associations between symptoms were highly correlated across MDD/BD (Spearman's r = 0.96, p<0.001). Network comparison tests showed no significant differences among MDD/BD in network strength, structure, or specific edges, with strong edges correlations (0.66-0.78). Upstream differences in MDD/BD may produce similar symptoms networks downstream during acute depression. Yet, mixed symptoms, appetite gain and hypersomnia are associated to BD rather than MDD. Symptoms during mixed-MDE might aggregate according to 2 different clusters, suggesting a possible stratification within mixed states. Future symptom-based studies should implement clinical, longitudinal, and biological factors, in order to establish tailored therapeutic strategies for acute depression.
Identifiants
pubmed: 32409261
pii: S0924-977X(20)30092-4
doi: 10.1016/j.euroneuro.2020.03.017
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
49-60Informations de copyright
Copyright © 2020. Published by Elsevier B.V.