Castle Peak Hospital, Hong Kong Special Administration Region, China.
Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.
Psych J. 2023 Jun;12(3):452-460. doi: 10.1002/pchj.635. Epub 2023 Mar 1.
Major depressive disorder (MDD) is associated with deficits in emotion experience, expression and regulation. Whilst emotion regulation deficits prolong MDD, emotion expression influences symptomatic presentations, and anticipatory pleasure deficits predict recurrence risk. Profiling MDD patients from an emotion componential perspective can characterize subtypes with different clinical and functional outcomes. This study aimed to investigate emotional subtypes of MDD. A two-stage cluster analysis applied to 150 MDD patients. Clustering variables included emotion experience measured by Temporal Experience of Pleasure Scale, emotion expression measured by Toronto Alexithymia Scale, and emotion regulation measured by Emotion Regulation Questionnaire. We validated the resultant clusters by comparing their symptoms and functioning with that of 50 controls. Cluster 1 (n = 50) exhibited intact emotion experience and expression yet adopted reappraisal rather than suppression strategy, whereas Cluster 2 (n = 66) exhibited generalized emotional deficits. Cluster 3 (n = 34) exhibited emotion expression deficits and adopted both reappraisal and suppression strategies. On validation, Cluster 2 exhibited the worst, but Cluster 1 exhibited the least symptoms and social functioning impairments. Cluster 3 was intermediate among the two other subtypes. Our findings support the existence of different emotional subtypes in MDD patients, and have clinical and theoretical implications for developing future specific treatments for MDD.
重度抑郁症（MDD）与情绪体验、表达和调节能力受损有关。虽然情绪调节缺陷会延长 MDD 的病程，但情绪表达会影响症状表现，而预期愉悦缺失则预示着复发风险。从情绪成分的角度对 MDD 患者进行分析可以确定具有不同临床和功能结局的亚型。本研究旨在探讨 MDD 的情绪亚型。采用两阶段聚类分析对 150 名 MDD 患者进行分析。聚类变量包括通过时间体验愉悦量表测量的情绪体验、通过多伦多述情障碍量表测量的情绪表达和通过情绪调节问卷测量的情绪调节。我们通过比较这些聚类的症状和功能与 50 名对照者的症状和功能来验证所得的聚类。聚类 1（n=50）表现出完整的情绪体验和表达，但采用了重新评估而不是抑制策略，而聚类 2（n=66）表现出广泛的情绪缺陷。聚类 3（n=34）表现出情绪表达缺陷，并同时采用重新评估和抑制策略。在验证过程中，聚类 2 表现出最差的症状和社会功能障碍，但聚类 1 表现出的症状和社会功能障碍最少。聚类 3 在另外两个亚型之间处于中间位置。我们的研究结果支持 MDD 患者存在不同的情绪亚型，这对开发针对 MDD 的特定治疗方法具有临床和理论意义。
