Defining Mood Disorder Subtypes Could Improve Treatment
Identifying subtypes within mood, anxiety, and trauma disorders could help improve the diagnosis and treatment of patients presenting with these disorders and to allieviate symptom overlap in conventional psychiatric diagnoses, according to the findings of a recent study.
To identify these transdiagnositic subtypes, the researchers used data from 420 individuals involved in the Brain Research and Integrative Neuroscience Network Foundation Database (mean age 39.8 years, 61% female). Machine learning was used to classify participants based on self-reported negative mood, anxiety, and stress symptoms and the generalizability of the subtypes were tested in independent samples. In addition, the researchers assessed whether symptom subtypes were expressed at the behavioral and physiological levels of function and whether there were any clinically meaningful differences in the functional capacity within subtypes.
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A total of 100 participants had been diagnosed with major depressive disorder, 53 with panic disorder, 47 with posttraumatic stress disorder, and 220 with no disorder.
The researchers identified 6 distinct subtypes, which were characterized by tension, anxious arousal, general anxiety, anhedonia, melancholia, and normative mood. These were replicated in the independent sample.
Additionally, they found that subtypes were expressed through differences in cognitive control, working memory, electroencephalography-recorded β power in a resting paradigm, electroencephalography-recorded β power in an emotional paradigm, social functional capacity, and emotional resilience.
“Identification of transdiagnostic subtypes that are coherent across symptom, behavioral, and neural levels may help disentangle the symptom overlap in conventional psychiatric diagnoses, ultimately guiding tailored treatment choices,” the researchers concluded.
—Melissa Weiss
Reference:
Grisanzio KA, Goldstein-Piekarski AN, Wang MY, Ahmed APR, Samara Z, Williams LM. Transdiagnostic symptom clusters and associations with brain, behavior, and daily function in mood, anxiety, and trauma disorders [published online December 3, 2017]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.3951.