识别重度抑郁障碍患者症状轨迹的潜在亚型及其预测因素。

IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY
Fanyu Meng, Wenwen Ou, Xiaotian Zhao, Mi Wang, Xiaowen Lu, Qiangli Dong, Liang Zhang, Jinrong Sun, Hua Guo, Futao Zhao, Mei Huang, Mohan Ma, Guanyi Lv, Yaqi Qin, Weihui Li, Zexuan Li, Mei Liao, Li Zhang, Jin Liu, Bangshan Liu, Yumeng Ju, Yan Zhang, Lingjiang Li
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引用次数: 0

摘要

本研究旨在根据两个月随访期间抑郁症状的严重程度确定不同的症状轨迹,并探索不同症状轨迹的预测因素。研究人员从两个纵向队列中招募了 392 名确诊患有重度抑郁障碍(MDD)的成年人。患者照常接受抗抑郁治疗,并在基线、两周和八周时使用 17 项汉密尔顿抑郁评分量表(HAMD-17)评估抑郁症状。根据 HAMD-17 评分,采用增长混合模型(GMM)区分了不同的症状变化轨迹。此外,还对基线社会人口学、临床和认知特征进行了比较,以确定不同轨迹的潜在预测因素。通过 GMM,确定了 MDD 患者三种独特的抑郁症状轨迹:(1) 有显著改善的轻度严重等级(轻度,n = 255);(2) 有显著改善的高度严重等级(高度,n = 39);(3) 改善有限的中度严重等级(有限,n = 98)。在这三种轨迹中,轻度组的基线焦虑症状水平相对较低,而高度组的受教育程度最低,认知表现最差。此外,"有限型 "参与者的发病年龄较早,并且遭受过更多的情感虐待。本研究可通过不同的症状轨迹将 MDD 患者分为三种不同的潜在亚型,这些亚型患者的特征可为确定特定轨迹的干预目标提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Identifying latent subtypes of symptom trajectories in major depressive disorder patients and their predictors.

Identifying latent subtypes of symptom trajectories in major depressive disorder patients and their predictors.

This study aimed to identify different symptom trajectories based on the severity of depression symptoms within a 2-month follow-up, and to explore predictive factors for different symptom trajectories. Three hundred and ninety-two adults diagnosed with major depressive disorder (MDD) were recruited from two longitudinal cohorts. Patients received antidepressant treatment as usual, and the depression symptoms were evaluated by the 17-item Hamilton depression rating scale (HAMD-17) at baseline, two weeks, and eight weeks. Based on the HAMD-17 scores, different trajectories of symptom change were distinguished by applying Growth Mixture Modeling (GMM). Furthermore, the baseline sociodemographic, clinical, and cognitive characteristics were compared to identify potential predictors for different trajectories. Through GMM, three unique depressive symptom trajectories of MDD patients were identified: (1) mild-severity class with significant improvement (Mild, n = 255); (2) high-severity class with significant improvement (High, n = 39); (3) moderate-severity class with limited improvement (Limited, n = 98). Among the three trajectories, the Mild class had a relatively low level of anxiety symptoms at baseline, whereas the High class had the lowest education level and the worst cognitive performance. Additionally, participants in the Limited class exhibited an early age of onset and experienced a higher level of emotional abuse. MDD patients could be categorised into three distinct latent subtypes through different symptom trajectories in this study, and the characteristics of these subtype patients may inform identifications for trajectory-specific intervention targets.

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来源期刊
CiteScore
8.80
自引率
4.30%
发文量
154
审稿时长
6-12 weeks
期刊介绍: The original papers published in the European Archives of Psychiatry and Clinical Neuroscience deal with all aspects of psychiatry and related clinical neuroscience. Clinical psychiatry, psychopathology, epidemiology as well as brain imaging, neuropathological, neurophysiological, neurochemical and moleculargenetic studies of psychiatric disorders are among the topics covered. Thus both the clinician and the neuroscientist are provided with a handy source of information on important scientific developments.
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