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Subtypes of major depression: latent class analysis in depressed Han Chinese women
- Y. Li, S. Aggen, S. Shi, J. Gao, Y. Li, M. Tao, K. Zhang, X. Wang, C. Gao, L. Yang, Y. Liu, K. Li, J. Shi, G. Wang, L. Liu, J. Zhang, B. Du, G. Jiang, J. Shen, Z. Zhang, W. Liang, J. Sun, J. Hu, T. Liu, X. Wang, G. Miao, H. Meng, Y. Li, C. Hu, Y. Li, G. Huang, G. Li, B. Ha, H. Deng, Q. Mei, H. Zhong, S. Gao, H. Sang, Y. Zhang, X. Fang, F. Yu, D. Yang, T. Liu, Y. Chen, X. Hong, W. Wu, G. Chen, M. Cai, Y. Song, J. Pan, J. Dong, R. Pan, W. Zhang, Z. Shen, Z. Liu, D. Gu, X. Wang, X. Liu, Q. Zhang, J. Flint, K. S. Kendler
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- Journal:
- Psychological Medicine / Volume 44 / Issue 15 / November 2014
- Published online by Cambridge University Press:
- 09 April 2014, pp. 3275-3288
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Background.
Despite substantial research, uncertainty remains about the clinical and etiological heterogeneity of major depression (MD). Can meaningful and valid subtypes be identified and would they be stable cross-culturally?
Method.Symptoms at their lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years, with recurrent DSM-IV MD. Latent class analysis (LCA) was performed in Mplus.
Results.Using the nine DSM-IV MD symptomatic A criteria, the 14 disaggregated DSM-IV criteria and all independently assessed depressive symptoms (n = 27), the best LCA model identified respectively three, four and six classes. A severe and non-suicidal class was seen in all solutions, as was a mild/moderate subtype. An atypical class emerged once bidirectional neurovegetative symptoms were included. The non-suicidal class demonstrated low levels of worthlessness/guilt and hopelessness. Patterns of co-morbidity, family history, personality, environmental precipitants, recurrence and body mass index (BMI) differed meaningfully across subtypes, with the atypical class standing out as particularly distinct.
Conclusions.MD is a clinically complex syndrome with several detectable subtypes with distinct clinical and demographic correlates. Three subtypes were most consistently identified in our analyses: severe, atypical and non-suicidal. Severe and atypical MD have been identified in multiple prior studies in samples of European ethnicity. Our non-suicidal subtype, with low levels of guilt and hopelessness, may represent a pathoplastic variant reflecting Chinese cultural influences.
The structure of the symptoms of major depression: exploratory and confirmatory factor analysis in depressed Han Chinese women
- Y. Li, S. Aggen, S. Shi, J. Gao, Y. Li, M. Tao, K. Zhang, X. Wang, C. Gao, L. Yang, Y. Liu, K. Li, J. Shi, G. Wang, L. Liu, J. Zhang, B. Du, G. Jiang, J. Shen, Z. Zhang, W. Liang, J. Sun, J. Hu, T. Liu, X. Wang, G. Miao, H. Meng, Y. Li, C. Hu, Y. Li, G. Huang, G. Li, B. Ha, H. Deng, Q. Mei, H. Zhong, S. Gao, H. Sang, Y. Zhang, X. Fang, F. Yu, D. Yang, T. Liu, Y. Chen, X. Hong, W. Wu, G. Chen, M. Cai, Y. Song, J. Pan, J. Dong, R. Pan, W. Zhang, Z. Shen, Z. Liu, D. Gu, X. Wang, X. Liu, Q. Zhang, J. Flint, K. S. Kendler
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- Journal:
- Psychological Medicine / Volume 44 / Issue 7 / May 2014
- Published online by Cambridge University Press:
- 07 August 2013, pp. 1391-1401
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Background
The symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome?
MethodSymptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples.
ResultsThe preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety.
ConclusionsMD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome.
Birth of rats following nuclear exchange at the 2-cell stage
- Sangho Roh, Jitong Guo, Nakisa Malakooti, John R. Morrison, Alan O. Trounson, Zhong Tao Du
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We report full-term development of nuclear transfer embryos following nuclear exchange at the 2-cell stage. Nuclei from 2-cell rat embryos were transferred into enucleated 2-cell embryos and developed to term after transfer to recipients (NT2). Pronuclear exchange in zygotes was used for comparison (NT1). Zygotes and 2-cell embryos were harvested from 4-week-old female Sprague-Dawley rats. Nuclear transfer was performed by transferring the pronuclei or karyoplasts into the perivitelline space of recipient embryos followed by electrofusion to reconstruct embryos. Fused couplets were cultured for 4 or 24 h before being transferred into day 1 pseudopregnant recipients (Hooded Wistar) at the 1- or 2-cell stage. In vitro culture was also carried out to check the developmental competence of the embryos. In vitro development to the blastocyst stage was not significantly different between the two groups (NT1, 34.3%; NT2, 45.0%). Two of three recipients from NT1 and two of five recipients from NT2 became pregnant. Six pups (3 from NT1, 3 from NT2) were delivered from the four foster mothers. Three female pups survived; 2 from NT1 and 1 from NT2. At 2 months of age these pups appeared healthy, and were mated with Sprague-Dawley males. One rat derived from NT1 delivered 15 pups (5 males, 10 females) as did the rat from NT2 (7 males, 8 females). Our results show that by using karyoplasts from 2-cell stage embryos as nuclear donors and reconstructing them with enucleated 2-cell embryos, healthy rats can be produced.