Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA; Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen The Netherlands.
Department of Psychology, University of Amsterdam, The Netherlands.
J Affect Disord. 2018 Feb;227:313-322. doi: 10.1016/j.jad.2017.10.038. Epub 2017 Oct 29.
Genetic risk and environmental adversity-both important risk factors for major depression (MD)-are thought to differentially impact on depressive symptom types and associations. Does heterogeneity in these risk factors result in different depressive symptom networks in patients with MD?
A clinical sample of 5784 Han Chinese women with recurrent MD were interviewed about their depressive symptoms during their lifetime worst episode of MD. The cases were classified into subgroups based on their genetic risk for MD (family history, polygenic risk score, early age at onset) and severe adversity (childhood sexual abuse, stressful life events). Differences in MD symptom network structure were statistically examined for these subgroups using permutation-based network comparison tests.
Although significant differences in symptom endorsement rates were seen in 18.8% of group comparisons, associations between depressive symptoms were similar across the different subgroups of genetic and environmental risk. Network comparison tests showed no significant differences in network strength, structure, or specific edges (P-value > 0.05) and correlations between edges were strong (0.60-0.71).
This study analyzed depressive symptoms retrospectively reported by severely depressed women using novel statistical methods. Future studies are warranted to investigate whether similar findings hold in prospective longitudinal data, less severely depressed patients, and men.
Similar depressive symptom networks for MD patients with a higher or lower genetic or environmental risk suggest that differences in these etiological influences may produce similar symptom networks downstream for severely depressed women.
遗传风险和环境逆境——都是重度抑郁症（MD）的重要危险因素——被认为会对抑郁症状类型和关联产生不同的影响。这些危险因素的异质性是否会导致 MD 患者的抑郁症状网络不同？
对 5784 名汉族反复发作 MD 的女性患者进行了采访，了解了她们一生中 MD 最严重发作期间的抑郁症状。根据 MD 的遗传风险（家族史、多基因风险评分、发病年龄早）和严重逆境（儿童性虐待、生活压力事件）将病例分为亚组。使用基于置换的网络比较检验统计检查了这些亚组的 MD 症状网络结构差异。
尽管在 18.8%的组间比较中观察到症状发生率存在显著差异，但抑郁症状之间的关联在遗传和环境风险的不同亚组中是相似的。网络比较检验显示网络强度、结构或特定边缘之间没有显著差异（P 值>0.05），边缘之间的相关性很强（0.60-0.71）。
本研究使用新的统计方法分析了重度抑郁女性回顾性报告的抑郁症状。未来的研究需要调查在前瞻性纵向数据、抑郁程度较轻的患者和男性中是否存在类似的发现。
具有较高或较低遗传或环境风险的 MD 患者的抑郁症状网络相似，这表明这些病因影响的差异可能会在下游为重度抑郁女性产生相似的症状网络。
