Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 179, Issue -, Pages 38-46Publisher
ELSEVIER
DOI: 10.1016/j.jad.2015.03.029
Keywords
Depression; Dimensions; Persistence; Subtypes; Prototypes; Latent class growth analysis
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Funding
- VICI grant from the Netherlands organization for Scientific research (NWO-ZonMW) [91812607]
- NWO Medical Sciences Program and Chronic Diseases Program
- Research Foundations of Health Insurance Company 'Het Groene Lind'
- Regional Health Insurance Company (RZG)
- Netherlands Foundation for Mental Health
- University Medical Center Groningen
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Background: The course-heterogeneity of Major Depressive Disorder (MDD) hampers development of better prognostic models. Although latent class growth analyses (LCGA) have been used to explain course-heterogeneity, such analyses have failed to also account for symptom-heterogeneity of depressive symptoms. Therefore, the aim was to identify more specific data-driven subgroups based on patterns of course-trajectories on different depressive symptom domains. Methods: In primary care MDD patients (n=205), the presence of the MDD criterion symptoms was determined for each week during a year Weekly 'mood/cognition' (MC) and 'somatic' (SOM) scores were computed and parallel processes-LCGA (PP-LCGA) was used to identify subgroups based on the course on these domains. The classes associations with baseline predictors and 2-13-year outcomes were investigated. Results: PP-LCGA identified four classes: quick recovery, persisting SOM, persisting MC, and persisting SOM I MC (chronic). Persisting SOM was specifically predicted by higher baseline somatic symptomatology and somatization, and was associated with more somatic depressive symptomatology at long-term follow-up. Persisting MC was specifically predicted by higher depressive severity, thinking insufficiencies, neuroticism, loneliness and lower self-esteem, and was associated with lower mental health related quality of life and more mood/cognitive depressive symptomatology at follow-up. Limitations: The sample was small and contained only primary care MDD patients. The weekly depression assessments were collected retrospectively at 3-month intervals. Conclusions: The results indicate that there are two specific prototypes of depression, characterized by either persisting MC or persisting SOM, which have different sets of associated prognostic factors and long-term outcomes, and could have different etiological mechanisms. (C). 2015 Elsevier By. All rights reserved
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