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Symptom networks in acute depression across bipolar and major depressive disorders: A network analysis on a large, international, observational study.
Journal article

Symptom networks in acute depression across bipolar and major depressive disorders: A network analysis on a large, international, observational study.

  • Corponi F Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.
  • Anmella G Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.
  • Verdolini N Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.
  • Pacchiarotti I Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.
  • Samalin L CHU Clermont-Ferrand, Department of Psychiatry, EA 7280, University of Clermont Auvergne, 58, Rue Montalembert, 63000 Clermont-Ferrand, France.
  • Popovic D Psychiatry B, Chaim Sheba Medical Center, Ramat-Gan, Israel.
  • Azorin JM AP HM, Psychiatric Pole, Sainte Marguerite, Marseille, France.
  • Angst J Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
  • Bowden CL Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States.
  • Mosolov S Department for Therapy of Mental Disorders, Moscow Research Institute of Psychiatry, Moscow, Russian Federation.
  • Young AH Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
  • Perugi G Department of Experimental and Clinical Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56100 Pisa, Italy.
  • Vieta E Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain. Electronic address: evieta@clinic.cat.
  • Murru A Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.
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  • 2020-05-16
Published in:
  • European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology. - 2020
Bipolar disorder
Cross-disorder
Depression
Mixed features
Network analysis
English 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.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/285016
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