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Stability and transitions of depressive subtypes over a 2-year follow-up

Published online by Cambridge University Press:  17 February 2012

F. Lamers*
Affiliation:
Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
D. Rhebergen
Affiliation:
Department of Psychiatry/EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
K. R. Merikangas
Affiliation:
Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
P. de Jonge
Affiliation:
Interdisciplinary Center for Psychiatric Epidemiology (ICPE), Department of Psychiatry and Department of Internal Medicine, University Medical Center Groningen, University of Groningen, The Netherlands
A. T. F. Beekman
Affiliation:
Department of Psychiatry/EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
B. W. J. H. Penninx
Affiliation:
Department of Psychiatry/EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Interdisciplinary Center for Psychiatric Epidemiology (ICPE), Department of Psychiatry and Department of Internal Medicine, University Medical Center Groningen, University of Groningen, The Netherlands Department of Psychiatry, Leiden University Medical Center, The Netherlands
*
*Address for correspondence: Dr F. Lamers, Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, 35 Convent Drive, Room 1A108, MSC 3720, Bethesda, MD 20892-3720, USA. (Email: lamersf@mail.nih.gov)

Abstract

Background

Identifying depressive subtypes is an important tool in reducing the heterogeneity of major depressive disorder. However, few studies have examined the stability of putative subtypes of depression over time.

Method

The sample included 488 persons from the Netherlands Study of Depression and Anxiety (NESDA) who had major depressive disorder at baseline and at the 2-year follow-up assessment. A latent transition analysis (LTA) was applied to examine the stability of depressive subtypes across time-points. Differences in demographic, clinical, psychosocial and health correlates between subtypes were evaluated in a subsample of persons with stable subtypes.

Results

Three subtypes were identified at each time-point: a moderate subtype (prevalence T0 39%, T1 42%), a severe typical subtype (T0 30%, T1 25%), and a severe atypical subtype (T0 31%, T1 34%). The LTA showed 76% stability across the 2-year follow-up, with the greatest stability in the severe atypical class (79%). Analyses of correlates in the stable subtypes showed a predominance of women and more overweight and obesity in the severe atypical subtype, and a greater number of negative life events and higher neuroticism and functioning scores in the severe typical subtype.

Conclusions

Subtypes of major depressive disorder were found to be stable across a 2-year follow-up and to have distinct determinants, supporting the notion that the identified subtypes are clinically meaningful.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012

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