Tracing the associations between sex, the atypical and the combined atypical-melancholic depression subtypes: A path analysis.
- Rodgers S Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland. Electronic address: stephanie.rodgers@dgsp.uzh.ch.
- Vandeleur CL Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
- Ajdacic-Gross V Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
- Aleksandrowicz AA Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
- Strippoli MF Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
- Castelao E Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
- Glaus J Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland; Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA.
- Lasserre AM Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
- Müller M Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
- Rössler W Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Brazil.
- Angst J Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
- Preisig M Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
- 2015-12-02
Published in:
- Journal of affective disorders. - 2016
Atypical and melancholic subtypes
Depression
Epidemiology
Sex
Adult
Age of Onset
Anxiety Disorders
Body Mass Index
Cross-Sectional Studies
Depression
Depressive Disorder, Major
Female
Humans
Male
Middle Aged
Sex Distribution
Switzerland
English
BACKGROUND
Numerous studies have examined determinants leading to preponderance of women in major depressive disorder (MDD), which is particularly accentuated for the atypical depression subtype. It is thus of interest to explore the specific indirect effects influencing the association between sex and established depression subtypes.
METHODS
The data of 1624 subjects with a lifetime diagnosis of MDD derived from the population-based PsyCoLaus data were used. An atypical (n=256), a melancholic (n=422), a combined atypical and melancholic features subtype (n=198), and an unspecified MDD group (n=748) were constructed according to the DSM-IV specifiers. Path models with direct and indirect effects were applied to the data.
RESULTS
Partial mediation of the female-related atypical and combined atypical-melancholic depression subtypes was found. Early anxiety disorders and high emotion-orientated coping acted as mediating variables between sex and the atypical depression subtype. In contrast, high Body Mass Index (BMI) served as a suppression variable, also concerning the association between sex and the combined atypical-melancholic subtype. The latter association was additionally mediated by an early age of MDD onset and early/late anxiety disorders.
LIMITATIONS
The use of cross-sectional data does not allow causal conclusions.
CONCLUSIONS
This is the first study that provides evidence for a differentiation of the general mechanisms explaining sex differences of overall MDD by depression subtypes. Determinants affecting the pathways begin early in life. Since some of them are primarily of behavioral nature, the present findings could be a valuable target in mental health care.
Numerous studies have examined determinants leading to preponderance of women in major depressive disorder (MDD), which is particularly accentuated for the atypical depression subtype. It is thus of interest to explore the specific indirect effects influencing the association between sex and established depression subtypes.
METHODS
The data of 1624 subjects with a lifetime diagnosis of MDD derived from the population-based PsyCoLaus data were used. An atypical (n=256), a melancholic (n=422), a combined atypical and melancholic features subtype (n=198), and an unspecified MDD group (n=748) were constructed according to the DSM-IV specifiers. Path models with direct and indirect effects were applied to the data.
RESULTS
Partial mediation of the female-related atypical and combined atypical-melancholic depression subtypes was found. Early anxiety disorders and high emotion-orientated coping acted as mediating variables between sex and the atypical depression subtype. In contrast, high Body Mass Index (BMI) served as a suppression variable, also concerning the association between sex and the combined atypical-melancholic subtype. The latter association was additionally mediated by an early age of MDD onset and early/late anxiety disorders.
LIMITATIONS
The use of cross-sectional data does not allow causal conclusions.
CONCLUSIONS
This is the first study that provides evidence for a differentiation of the general mechanisms explaining sex differences of overall MDD by depression subtypes. Determinants affecting the pathways begin early in life. Since some of them are primarily of behavioral nature, the present findings could be a valuable target in mental health care.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.jad.2015.10.067
- PMID 26625093
- Persistent URL
- https://sonar.rero.ch/global/documents/40660
Statistics
Document views: 20
File downloads:
- fulltext.pdf: 0