The structure of the symptoms of major depression: exploratory and confirmatory factor analysis in depressed Han Chinese women

Abstract

BackgroundThe 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.

Study of prodromal and residual symptoms of depression

“…[4] A team of Chinese investigators identify different factors of major depression apart from depressive symptom factors, namely vegetative symptoms, cognitive symptoms, and agitated symptoms factors, of which agitated factors are characterized by anxiety and irritability. [22] It can be argued that the irritability as a prodrome may be genetically determined, but irritability as a symptom in active depression may not be specific to genetic association. There is evidence to suggest that irritability in depression may be associated with atypical features, mixed state, and bipolar diathesis.…”

Prevalence and Predictors of Metabolic Syndrome in People With Schizophrenia in Inpatient Rehabilitation Wards

“…The results of the current study thus differ from those of these previous studies. Poor appetite is a typical symptom of patients experiencing a depressive mood (Li et al, 2014). People who have depressive symptoms may fear socializing with others and are likely to reduce the frequency of this activity (Rice, Grealy, Javaid, & Millan Serrano, 2011).…”

A comprehensive model of predictors of persistence and recurrence in adults with major depression: Results from a national 3-year prospective study

“…We built upon the CFA model fit by Blanco et al (Blanco et al, 2013; Magidson et al, 2014) with these data, which generated 3 dimensions (“internalizing I”, “internalizing II” and “externalizing”) and performed a bifactor CFA model to determine whether a general psychopathology factor measured by all mental disorders in addition to whether disorder-specific factors fit the underlying structure of mental disorders. Second, we performed the CFA model fit by Li et al (Li et al, 2014), which generated a 3-factor structure of 14 disaggregated DSM-IV symptoms of MDE (see Table 1), to determine whether these three symptom-specific factors fit the underlying structure of depression with our data. We examined measures of goodness-of-fit, including the comparative fit index (CFI), the Tucker– Lewis index (TLI), and the root mean squared error of approximation (RMSEA).…”

“…We examined measures of goodness-of-fit, including the comparative fit index (CFI), the Tucker– Lewis index (TLI), and the root mean squared error of approximation (RMSEA). CFI and TLI values between 0.90 and 0.95 are considered acceptable, and CFI and TLI values greater than 0.95 and values of RMSEA less than 0.06 indicate good model fit (Hu and Bentler, 1999; Li et al, 2014). …”