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Classification and Characteristics of Depression Subtypes: Latent Class Analysis

Abstract

Confirming the heterogeneity in depression may be useful in the its diagnosis, treatment and prevention. The purpose of this study was to identify the subtypes of depression and characteristics associated with it using data from clinical samples. Analyses were based on samples from 1,180 respondents from 19 psychiatric hospitals which had been registered in the Clinical Research Center for Depression. Latent class analysis was administered using responses from the Hamilton Depression Scale to identify a homogenous subtype of depression. Association between emergent latent classes and demographic and clinical characteristics were assessed. As a result, three subtypes of depression were identified: severely depressed, affective depressed, and mild depressed. The severely depressed subtype had more suicidal tendencies than the other groups. The affective depressed subtype tended to be as depressive as the severely depressed class, but without psycho-motor symptoms as compared to the other groups. In addition, the affective depressed subtype had more sleep disorder than the other groups. Based on a three-month follow-up study, the severly depressed subtype exhibited more serious and persistent depression. The implications and limitations of this study were also discussed.

keywords
depression, subtypes, latent class analysis, Hamilton Depression Scale, 우울증, 하위유형, 잠재적 집단 분석, 해밀턴 우울척도

Reference

1.

김정범 외 (2006). 벡 우울증 질문지 2판. 하나의보건복지부 지정 우울증 임상연구 2세부 연차보고서.

2.

김진영, 최승미, 서국희, 조성진, 김장규, 조맹제 (2000). 한국인 우울증상표현의 횡문화적 차이-CES-D의 요인구조분석. 정신병리학, 1, 78-87.

3.

김창윤 외 (2001). 정신장애 평가도구. 하나의학사.

4.

박혜원, 이은호, 김도관, 유범희, 이동수, 김지혜 (2009). 한국판 해밀턴 우울증평가척도(K-HDRS)의 확인적 요인 분석. Journal of Korean Neuropsychiatric Assocaiation, 48, 21-28.

5.

신민섭, 박광배, 오경자, 김중술 (1990). 고등학생의 자살성향에 관한 연구: 우울-절망-자살간의 구조적인 관계에 대한 분석. 한국심리학회지: 임상, 9, 1-19.

6.

이중서, 배승오, 안용민, 박두병, 노경선, 신현균, 우행원, 이홍식, 한상익, 김용식 (2005). 한국판 Hamilton 우울증 평가척도의 신뢰도, 타당도 연구. 대한신경정신의학회, 44, 456-465.

7.

이지현, 장정기, 박지홍, 안준호, 이철, 김창윤 (2003). 해밀턴 우울증 평가척도의 요인구조. 정신병리학, 12, 3-16.

8.

장성만, 손지훈, 이준영, 최지환, 조성진, 전홍진, 함봉진, 이동현, 조맹제 (2007). 한국인의 우울증 진단 기준의 특성. 정신병리학, 46, 447-452.

9.

정성원, 김정범 (2010). 우울증의 척도 및 진단도구의 개발. 우울증 치료연구의 발전을 위한 우울증 임상연구센터 3 세부과제 & 한국보건의료연구원(NECA) 공동심포지엄, 20.

10.

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorder, (4th ed.). Washington, DC.

11.

Angst, J., & Merikangas, K. R. (2001). Multi- dimensional criteria for the diagnosis of depression. Journal of Affective Disorder, 62, 7-15.

12.

Baglioni, C., Spiegelhalder, K., Lombardo, C., & Riemann, D. (2010). Sleep and emotions: A focus on insomnia. Sleep Medicine Reviews, 14, 227-238.

13.

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory- second edition manual. San Antonio, TX: The Psychological Corporation.

14.

Butterworth, P., Rodgers, B., & Windsor, T. D. (2009). Financial hardship, socio-economic position and depression: results from the PATH through life survey. Social Science & Medicine, 229-237.

15.

Cassano, G. B., Benvenuti, A., Miniati, M., Calugi, S., Mula, M., Maggi, L., Rucci, P., Fagiolini, A., Perris, F. & Frank, E. (2009). The factor structure of lifetime depressive spectrum in patients with unipolar depression. Journal of Affective Disorder, 115, 87-99.

16.

Carragher, N., Adamson G., Bunting, B., & McCann, S. (2009). Subtypes of depression in nationally representative sample. Journal of Affective Disorder, 113, 88-99.

17.

Chang, S. M., Hahm, B. J., Lee, J. Y., Shin, M. S., Jeon, H. J., Hong J. P., Lee, H. B., Lee, D. W., & Cho, M. J. (2008). Cross- national difference in the prevalence of depression caused by the diagnostic threshold. Journal of Affective Disorder, 106, 159-167.

18.

Chen, L., Eaton, W. W., Gallo J. J., & Nestadt, G. (2000). Understanding the heterogeneity of depression through the triad of symptoms, course and risk factors: a longitudinal population-based study. Journal of Affective Disorder, 59, 1-11.

19.

Ferdinand, R. F., Nijs P. F., Lier, P., & Verhulst, F. C. (2005). Latent class analysis of anxiety and depressive symptoms in referred adolescents. Journal of Affective Disorder, 88, 299-306.

20.

Flett, G. L., Vredenberg, K., & Krames, L. (1997). The continuity of depression in clinical and nonclinical samples. Psychological Bulletin, 121, 395-416.

21.

Fostick, L., Silberman, A., Beckman, M., Spivak, B., & Amital, D. (2010). The economic impact of depression: resistance or severety? Psychological Bulletin European Neuropsychopharmacology, doi: 10.1016 /j.euroneuro.2010.06.001.

22.

Furukawa, T. A., Streiner, D. L., Azuma, H., Higuchi, T., Kamijima, K., Kanba, S. et al. (2005). Cross-cultural equivalence in depression assessment: Japan-Europe-North American study. Acta Psychiatrica Scandinavica, 112, 279-285.

23.

Gaudiano, B. A., Young, D., Chelminski, I., & Zimmerman, M. (2008). Depressive symptom profiles and severity patterns in outpatients with psychotic vs nonpsychotic major depression. Comprehensive Psychiatry, 49, 421-429.

24.

Hamilton, M. A. (1960). A rating scale for depression. Journal of Neurology, Neourosurgery, and Psychiatry, 23, 56-62.

25.

Keller, J., Schatzberg, A. F., & Maj, M. (2007). Current issues in the classification of psychotic major depression. Schizophrenia Bulletin, 33, 877-885.

26.

Lamers, F., Jonge, P., Nolen, W. A., Smit J. H., Zitman F. G., Beekman, A. T., & Penninx B. W. (2010). Identifying depressive subtypes in a large cohort study: results from the Netherlands study of depression and anxiety (NESDA) Journal of Clinical Psychiatry. 13, e1-e8.

27.

Lanza, S. T., Collins, L. M., Lemmon, D. R., & Schafer, J. L. (2007). PROC LCA: A SAS procedure for latent class analysis. Structural Equation Modeling, 14, 671-694.

28.

Lo, Y., Mendell, N. R., & Robin, D. B. (2001). Testing the number of components in a normal mixture. Biometrika 88, 767-778.

29.

Lux, V., Aggen, S. H., & Kendler, K. S. (2010). DSM-Ⅳdefinition of severity of major depression: inter-relationship and validity. Psychological Medicine, 1-11.

30.

National Institute of Mental Health (1976). Clinical Global Impressions In: ECDEU Assessment Manual for Psychopharmacology, rev. ed, Ed by Guy W., 218-222.

31.

Nylund, K. L., Asparouhov, T., & Muthen B. (2007). Decieding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling, 14, 535-569.

32.

Pancheri, P., Picardi., A., Pasquini, M., Gaetano, P., & Biondi, M. (2002). Psychopathological dimensions of depression: a factor study of the 17-item Hamilton depression rating scale in unipolar depressed outpatients. Journal of Affective Disorder, 68, 41-47.

33.

Prisciandaro., J. J., Roberts, J. E. (2009). Psychopathological dimensions A comparison of the predictive abilities of dimensional and categorical models of unipolar depression in the National Comorbidity Survey. Psychological Medicine, 39, 1087-1096.

34.

Santor, D. A., & Coyne, J. C. (2001). Examining symptom expression as function of symptom severity: item performance on the hamilton rating scale for depression. Psychological Assessment, 13, 127-139.

35.

Schrijvers, D., Hulstijn, W., & Sabbe, B. (2008). Psychomotor symptoms in depression: a diagnostic, pathophysiological and therapeutic tool. Journal of Affective Disorder, 109, 1-20.

36.

Sobin, C., & Sackeim, H. A. (1997). Psychomotor symptoms of depression. American Journal of Psychiatry, 154, 4-17.

37.

Solomon, A.k Haaga D. A. F., & Arnow B. A. (2001). Is clinical depression distinct from subthreshold depressive symptoms? a review of the continuity issue in depression research. Journal of Nervous and Mental diesease, 189, 498-506.

38.

Sullivan, P. F., Prescott, C. A., & Kendler, K. S. (2007). The subtypes of major depression in a twin registry. Journal of Affective Disorder, 68, 273-284.

39.

Weissman, M. M., Bland, R. C., Canino, G. J., Faravelii, C., Greenwald, S., Hwu, H. G., Joyce, P. R., Karam, E. G., Lee, C. K., Lellouch, J., Lepine, J. P., Newman, S. C., Rubio-Stipec, M., Wells, J. E., Wickramaratne, P. J., Wittchramaratne, P. J., Wittchen, H., Yeh, E. K. (1996). Cross-national epidemiology of major depression and bipolar disorder. JAMA 276, 293-299.

40.

Witte, T. K., Timmons, K. A., Fink, E., Smith, A. R., & Joiner, T. E. (2007). Do major depressive disorder and dythymic disorder confer differential risk for suicide? Journal of Affective Disorder, 115, 69-78.

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