Symptom network connectivity in adolescents with comorbid major depressive disorder and social phobia

Abstract

Major depressive disorder (MDD) and social phobia (SP) are both common and highly co-occurring psychiatric disorders. This study used symptom network analysis approach to examine comorbidity structure and the complex symptom dynamics which may play a role in the co-occurrence of MDD and SP. Method: Data comes from the National Comorbidity Survey-Adolescent Supplement, a nationally representative survey of adolescents ages 13 to 18 years. This study examined data of adolescents with a lifetime diagnosis of MDD (n = 597), SP (n = 708), and adolescents with comorbid MDD and SP (n = 189). Networks were estimated by means of 26 symptoms from both disorders. Results: All MDD and SP symptoms were involved in the network of both pure disorders and comorbid condition. Network structure was different between the pure disorders (p = .014), but not when comparing each of these disorders that have comorbid condition. Depressive symptoms of poor self-esteem and suicidal symptoms were central (i.e., showed a higher influence) in the symptom network for the pure disorders and for the comorbid condition. Other key symptoms in the comorbid condition network were two depressive symptoms: feelings of worthlessness and anhedonia. SP and MDD networks showed two common key SP symptoms: feeling uncomfortable when meeting new people and feeling uncomfortable talking to people do not know well. Conclusion: The study of symptom dynamics will provide useful targets for preventing the development of comorbid disorders as well as new lines of intervention to deal with key symptoms of psychiatric disorders.

Evidence for Specific Associations Between Depressive Symptoms, Psychotic Experiences, and Suicidal Ideation in Chilean Adolescents From the General Population

“…Although the age ranges of both samples are similar, direct comparisons must be interpreted with caution, considering we analyzed a narrower range of DS. Our results are also partially consistent with other recent network analysis conducted with adolescent patients reporting that in patients with both major depressive disorder (MDD), social phobia and (SP) and MDD+SP, poor self-esteem and suicidal ideation were the most central, in addition to feelings of worthlessness and anhedonia in the MDD+SP subgroup (68), and with another study reporting that fatigue and low mood as the most central nodes (69).…”

Comorbidity between depression and anxiety: assessing the role of bridge mental states in dynamic psychological networks

“…Multiple cross-sectional network studies have addressed comorbidity between depressive and anxiety disorders [10,[16][17][18][19][20][21][22][23][24][25][26]. In these studies, symptoms of both diagnoses were combined into one network structure, with symptom connections reflecting the statistical relationships between symptoms when the value of all other symptoms variables is controlled for.…”

“…In these studies, symptoms of both diagnoses were combined into one network structure, with symptom connections reflecting the statistical relationships between symptoms when the value of all other symptoms variables is controlled for. Symptoms belonging to the same disorder tended to be more strongly connected to symptoms of the same disorder than to symptoms of the other, comorbid disorder ( [15,16,[18][19][20][21][22][23][24][25][26], but see [10] as exception). Each study identified at least one symptom in the network that connected both to symptoms of the same disorder and to the symptom cluster belonging to the second, comorbid disorder.…”

Effects of a transdiagnostic cognitive behaviour therapy-based programme on the natural course of anxiety symptoms in adolescence

“…In the last decades, mounting evidence has provided some insight into the commonalities of internalising disorders (anxiety and depression), in terms of common neurophysiological underpinnings (e.g., hypothalamus-pituitaryadrenals dysregulation, sympathetic withdrawal when confronting stressful situations), psychopathological manifestations (e.g., low self-confidence, worry and rumination, fatigue, etc.) or shared genetic liability (Barlow et al, 2004;Beauchaine and Thayer, 2015;de Carvalho et al, 2014;de la Torre-Luque & Essau, 2019;de la Torre-Luque et al, 2016). Adolescents with an anxiety disorder have up to 29 times the risk of developing depression (Costello et al, 2003).…”