Abstract

BackgroundGiven the high comorbidity and shared risk factors between depression and anxiety, whether they represent theoretically distinct disease entities or are just characteristics of a common negative affect dimension remains debated. Employing a data-driven and person-centered approach, the present study aims to identify meaningful and discrete symptom patterns of the occurrence of depression and anxiety.MethodsUsing data from an adult sample from the Japanese general population (n = 403, including 184 females, age = 42.28 ± 11.87 years), we applied latent class analysis to identify distinct symptom patterns of depression (PHQ-9) and anxiety (STAI Y1). To empirically validate the derived class memberships, we tested the association between the derived classes and personal profiles including childhood experiences, life events, and personality traits.ResultsThe best-fitting solution had four distinct symptom patterns or classes. Whereas both Class 1 and 2 had high depression, Class 1 showed high anxiety due to high anxiety-present symptoms (e.g., “I feel nervous”) while Class 2 showed moderate anxiety due to few anxiety-absent symptoms (e.g., “I feel calm”). Class 3 manifested mild anxiety symptoms due to lacking responses on anxiety-absent items. Class 4 manifested the least depressive and anxiety-present symptoms as well as the most anxiety-absent symptoms. Importantly, whereas both Class 1 and 2 had higher childhood neglect and reduced reward responsiveness, etc. compared to Class 4 (i.e., the most healthy class), only Class 1 had greater negative affect and reported more negative life events.ConclusionsTo our knowledge, this is the first latent class analysis that examined the symptom patterns of depression and anxiety in Asian subjects. The classes we identified have distinct features that confirm their unique patterns of symptom endorsement. Our findings may provide insights into the etiology of depression, anxiety, and their comorbidity.

Highlights

  • Depressive and anxiety disorders are the most common mental health diseases and causes enormous burden to the society [1]

  • The study was part of a larger study conducted between January and August 2014 that aimed to investigate the interaction of early life stress, recent life events, and vulnerability in affecting depression, anxiety, and wellbeing in the Japanese general adult population

  • To select the best fitting model, we examined the Akaike information criteria (AIC), Bayesian information criteria (BIC), SSA-BIC, entropy, the LoMendell-Rubin adjusted likelihood ratio test (LMR-LRT), and the bootstrap likelihood ratio test (BLRT)

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Summary

Introduction

Depressive and anxiety disorders (hereafter, depression, and anxiety) are the most common mental health diseases and causes enormous burden to the society [1]. In addition to the high comorbidity, the two disorders have similar somatic symptoms, such as difficulty in sleeping and fatigue, and neuroendocrine profiles, such as the dysregulation of corticotropin-releasing factor [7]. They share substantial genetic risks [8] and have common psychopathological risk factors such as adverse childhood experience, negative life events, and enhanced sensitivity to punishment [9,10,11,12]. Given the high comorbidity and shared risk factors between depression and anxiety, whether they represent theoretically distinct disease entities or are just characteristics of a common negative affect dimension remains debated. Employing a data-driven and person-centered approach, the present study aims to identify meaningful and discrete symptom patterns of the occurrence of depression and anxiety

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