Association of Symptom Network Structure With the Course of Depression

作者：Claudia D. van Borkulo, Lynn Boschloo, Denny Borsboom, Brenda W.J.H. Penninx, Lourens Waldorp, Robert A. Schoevers · 发表于：JAMA Psychiatry · 年份：2015 · DOI：10.1001/jamapsychiatry.2015.2079 · 被引用次数：889 · 研究领域：Mental Health Research Topics、Functional Brain Connectivity Studies、Personality Disorders and Psychopathology

IMPORTANCE: Major depressive disorder (MDD) is a heterogeneous condition in terms of symptoms, course, and underlying disease mechanisms. Current classifications do not adequately address this complexity. In novel network approaches to psychopathology, psychiatric disorders are conceptualized as complex dynamic systems of mutually interacting symptoms. This perspective implies that a more densely connected network of symptoms is indicative of a poorer prognosis, but, to date, no previous study has examined whether network structure is indeed associated with the longitudinal course of MDD. OBJECTIVE: To examine whether the baseline network structure of MDD symptoms is associated with the longitudinal course of MDD. DESIGN, SETTING, AND PARTICIPANTS: In this prospective study, in which remittent and persistent MDD was defined on the basis of a follow-up assessment after 2 years, 515 patients from the Netherlands Study of Depression and Anxiety with past-year MDD (established with the Composite International Diagnostic Interview) and at least moderate depressive symptoms (assessed with the Inventory of Depressive Symptomatology [IDS]) at baseline were studied. Baseline starting and ending dates were September 1, 2004, through February 28, 2007. Follow-up starting and ending dates were September 1, 2006, through February 28, 2009. Analysis was conducted August 2015. The MDD was considered persistent if patients had at least moderate depressive symptoms (IDS) at 2-year follow-up; ...