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Network analysis of the depressive symptom profiles in Asian patients with depressive disorders: Findings from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD)

Park SC 1 , Jang EY 2 , Xiang YT 3 , Kanba S 4 , Kato TA 4 , Chong MY 5 Show all authors , Lin SK 6 , Yang SY 7 , Avasthi A 8 , Grover S 8 , Kallivayalil RA 9 , Udomratn P 10 , Chee KY 11 , Tanra AJ 12 , Tan CH 13 , Sim K 14 , Sartorius N 15 , Park YC 16 , Shinfuku N 17

Affiliations 

  • 1 Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
  • 2 Department of Counseling Psychology, Honam University College of Humanities and Social Sciences, Gwangju, Republic of Korea
  • 3 Faculty of Health Sciences, University of Macau, Macau, China
  • 4 Department of Neuropsychiatry, Graduate School of Medicine, Kyushu University, Fukuoka, Japan
  • 5 Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung & Chang Gung University School of Medicine, Linkou, Taiwan
  • 6 Psychiatry Center, Tapei City Hospital, Taipei, Taiwan
  • 7 Department of Pharmacy, Taipei City Hospital and Fu Jen University, Taipei, Taiwan
  • 8 Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
  • 9 Pushpagiri Institute of Medical Sciences, Tiruvalla, India
  • 10 Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
  • 11 Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur, Malaysia
  • 12 Faculty of Medicine, Department of Psychiatry, Hasanuddin University, Makassar, Indonesia
  • 13 Department of Pharmacology, National University Hospital, Singapore
  • 14 Institute of Mental Health, Buangkok Green Medical Park, Singapore
  • 15 Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
  • 16 Department of Neuropsychiatry, Hanyang University Guri Hospital, Guri, Republic of Korea
  • 17 Department of Social Welfare, School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan
Psychiatry Clin Neurosci, 2020 Jun;74(6):344-353.
PMID: 32048773 DOI: 10.1111/pcn.12989

Abstract

AIM: We aimed to estimate the network structures of depressive symptoms using network analysis and evaluated the geographic regional differences in theses network structures among Asian patients with depressive disorders.

METHODS: Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD), the network of the ICD-10 diagnostic criteria for depressive episode was estimated from 1174 Asian patients with depressive disorders. The node strength centrality of all ICD-10 diagnostic criteria for a depressive episode was estimated using a community-detection algorithm. In addition, networks of depressive symptoms were estimated separately among East Asian patients and South or Southeast Asian patients. Moreover, networks were estimated separately among Asian patients from high-income countries and those from middle-income countries.

RESULTS: Persistent sadness, fatigue, and loss of interest were the most centrally situated within the network of depressive symptoms in Asian patients with depressive disorders overall. A community-detection algorithm estimated that when excluding psychomotor disturbance as an outlier, the other nine symptoms formed the largest clinically meaningful cluster. Geographic and economic variations in networks of depressive symptoms were evaluated.

CONCLUSION: Our findings demonstrated that the typical symptoms of the ICD-10 diagnostic criteria for depressive episode are the most centrally situated within the network of depressive symptoms. Furthermore, our findings suggested that cultural influences related to geographic and economic distributions of participants could influence the estimated depressive symptom network in Asian patients with depressive disorders.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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