Temporal Directionality Between Symptoms During Treatment of Depressed Inpatients: A Dynamic Time Warp Network Analysis

IF 3.2 3区 心理学 Q1 PSYCHOLOGY, CLINICAL
Daphne A. Cocx-Swiebel, Gabrielle van Son, Anita Scheper, Mirella Stuivenga, Bernard Sabbe, Kaat Hebbrecht, Erik J. Giltay
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Abstract

Background

Depression is generally perceived from the perspective of the common-cause disease model. However, the network perspective assumes mutual influence of individual symptoms and stresses the importance of investigating symptom dynamics. Gaining a better understanding of symptom dynamics within individuals might contribute to more effective treatments.

Methods

Current exploratory longitudinal research studied the associations and directionality between 43 symptoms from the generic questionnaire Symptom Questionnaire-48 (SQ-48) using dynamic time warp (DTW) analyses, in which trajectories with similar time-dependent patterns can be identified. Data from individuals were analysed first, yielding distance matrices for all symptom trajectories, after which the data were aggregated.

Results

The 148 included patients were all admitted for the treatment of their clinical depression. Undirected DTW analyses of three patients with longer time series but otherwise randomly chosen showed large variability among individuals. Group-level undirected DTW analyses showed numerous significant edges between symptoms, largely clustering symptoms according to the eight pre-existing subscales of the SQ-48. Group-level directed DTW analyses showed five symptoms with significant outstrength: ‘hopeless’, ‘restless’, ‘down/depressed’, ‘feeling tense’ and ‘no enjoyment’, meaning that change in these key symptoms preceded change in other symptoms.

Limitations

The 43 included symptoms of the SQ-48 primarily focus on internalizing problems in severely depressed inpatients, potentially limiting generalizability.

Conclusions

DTW networks provided us with five key symptoms based on the dynamics of symptom scores. Future studies could explore whether process-based therapy targeted at symptoms with high outstrength might result in more effectivity as part of personalized treatment.

Abstract Image

抑郁症住院患者治疗期间症状之间的时间方向性:动态时间扭曲网络分析
背景:人们通常从常见病因模式的角度来看待抑郁症。然而,网络观点认为个体症状之间存在相互影响,并强调了调查症状动态的重要性。更好地了解个体的症状动态可能有助于更有效的治疗:目前的探索性纵向研究使用动态时间扭曲(DTW)分析法研究了通用问卷《症状问卷-48》(SQ-48)中 43 种症状之间的关联性和方向性。首先对个人数据进行分析,得出所有症状轨迹的距离矩阵,然后对数据进行汇总:结果:所纳入的 148 名患者均因治疗临床抑郁症而入院。对三名时间序列较长但随机选择的患者进行的非定向 DTW 分析表明,个体之间存在很大差异。组级非定向 DTW 分析表明,症状之间存在许多显著的边缘,主要是根据 SQ-48 中预先存在的八个分量表对症状进行了分组。组级定向 DTW 分析表明,有五个症状具有明显的外倾性:"绝望"、"不安"、"沮丧/抑郁"、"紧张 "和 "无乐趣",这意味着这些关键症状的变化先于其他症状的变化:局限性:SQ-48 包含的 43 个症状主要集中在严重抑郁住院患者的内化问题上,这可能会限制其普遍性:DTW网络根据症状评分的动态变化为我们提供了五种关键症状。未来的研究可以探索针对高强度症状的过程性治疗是否会作为个性化治疗的一部分产生更大的效果。
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来源期刊
Clinical psychology & psychotherapy
Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-
CiteScore
6.30
自引率
5.60%
发文量
106
期刊介绍: Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.
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