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Observational Study
. 2019 Feb;139(2):194-205.
doi: 10.1111/acps.12987. Epub 2018 Dec 9.

Severity, course trajectory, and within-person variability of individual symptoms in patients with major depressive disorder

W A van Eeden  1 , A M van Hemert  1 , I V E Carlier  1 , B W Penninx  2 , E J Giltay  1
Affiliations
Observational Study

Severity, course trajectory, and within-person variability of individual symptoms in patients with major depressive disorder

W A van Eeden et al. Acta Psychiatr Scand. 2019 Feb.

Abstract

Background: Depression shows a large heterogeneity of symptoms between and within persons over time. However, most outcome studies have assessed depression as a single underlying latent construct, using the sum score on psychometric scales as an indicator for severity. This study assesses longitudinal symptom-specific trajectories and within-person variability of major depressive disorder over a 9-year period.

Methods: Data were derived from the Netherlands Study of Depression and Anxiety (NESDA). This study included 783 participants with a current major depressive disorder at baseline. The Inventory Depressive Symptomatology-Self-Report (IDS-SR) was used to analyze 28 depressive symptoms at up to six time points during the 9-year follow-up.

Results: The highest baseline severity scores were found for the items regarding energy and mood states. The core symptoms depressed mood and anhedonia had the most favorable course, whereas sleeping problems and (psycho-)somatic symptoms were more persistent over 9-year follow-up. Within-person variability was highest for symptoms related to energy and lowest for suicidal ideation.

Conclusions: The severity, course, and within-person variability differed markedly between depressive symptoms. Our findings strengthen the idea that employing a symptom-focused approach in both clinical care and research is of value.

Keywords: affective disorders; depression; psychopathology.

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Figures

Figure 1
Figure 1
Group‐level mean item scores over the course of 9 years.
Figure 2
Figure 2
Unadjusted 1‐year slope represents the decrease in symptom severity after the first year of follow‐up. Negative values represent a steeper decline. Sum score adjusted 9‐year slope represents the decline in symptom severity in relation to the sum score. Negative values mean that the symptom had a steeper decline compared to the overall sum score.
Figure 3
Figure 3
Within‐person variability based on 8 years follow‐up (baseline excluded)
See this image and copyright information in PMC

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