Kim Han Seul, Lee Seonjae, Lee Jeongha, Choi Tae Young, Jung Sung-Won, Yoon Hyung-Jun, Kim Hyun Soo, Kim Yangsik, Yang Hyun-Ju, Jeong Narae, Moon Eunsoo, Kim Daeho, Si Tian-Mei, Kallivayalil Roy Abraham, Tanra Andi J, Nadoushan Amir Hossein Jalali, Chee Kok Yoon, Javed Afzal, Sim Kang, Pariwatcharakul Pornjira, Chong Mian-Yoon, Inada Toshiya, Lin Shih-Ku, Sartorius Norman, Shinfuku Naotaka, Kato Takahiro A, Lee Jae-Hon, Park Seon-Cheol
Department of Psychiatry, Hanyang University Medical Centre, Seoul, Republic of Korea.
Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
Acta Neuropsychiatr. 2025 Jun 20:1-49. doi: 10.1017/neu.2025.10020.
Depression is a complex mental health disorder with highly heterogeneous symptoms that vary significantly across individuals, influenced by various factors, including sex and regional contexts. Network analysis is an analytical method that provides a robust framework for evaluating the heterogeneity of depressive symptoms and identifying their potential clinical implications.
To investigate sex-specific differences in the network structures of depressive symptoms in Asian patients diagnosed with depressive disorders, using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3, which was conducted in 2023.
A network analysis of 10 depressive symptoms defined according to the National Institute for Health and Care Excellence guidelines was performed. The sex-specific differences in the network structures of the depressive symptoms were examined using the Network Comparison Test. Subgroup analysis of the sex-specific differences in the network structures was performed according to geographical region classifications, including East Asia, Southeast Asia, and South or West Asia.
A total of 998 men and 1,915 women with depression were analysed in this study. The analyses showed that all 10 depressive symptoms were grouped into a single cluster. Low self-confidence and loss of interest emerged as the most central nodes for men and women, respectively. In addition, a significant difference in global strength invariance was observed between the networks. In the regional subgroup analysis, only East Asian men showed two distinct clustering patterns. In addition, significant differences in global strength and network structure were observed only between East Asian men and women.
The study highlights the sex-specific differences in depressive symptom networks across Asian countries. The results revealed that low self-confidence and loss of interest are the main symptoms of depression in Asian men and women, respectively. The network connections were more localised in men, whereas women showed a more diverse network. Among the Asian subgroups analysed, only East Asians exhibited significant differences in network structure. The considerable effects of neurovegetative symptoms in men may indicate potential neurobiological underpinnings of depression in the East Asian population.
抑郁症是一种复杂的心理健康障碍，症状高度异质，个体间差异显著，受多种因素影响，包括性别和地区背景。网络分析是一种分析方法，为评估抑郁症状的异质性及其潜在临床意义提供了一个强大的框架。
利用2023年开展的亚洲抗抑郁药精神药物处方模式研究第三阶段的数据，调查亚洲抑郁症患者抑郁症状网络结构中的性别差异。
对根据英国国家卫生与临床优化研究所指南定义的10种抑郁症状进行网络分析。使用网络比较测试检查抑郁症状网络结构中的性别差异。根据地理区域分类，包括东亚、东南亚和南亚或西亚，对网络结构中的性别差异进行亚组分析。
本研究共分析了998名男性和1915名女性抑郁症患者。分析表明，所有10种抑郁症状都归为一个单一聚类。自信心低落和兴趣丧失分别成为男性和女性最核心的节点。此外，观察到各网络之间在全局强度不变性方面存在显著差异。在区域亚组分析中，只有东亚男性表现出两种不同的聚类模式。此外，仅在东亚男性和女性之间观察到全局强度和网络结构的显著差异。
该研究突出了亚洲国家抑郁症状网络中的性别差异。结果显示，自信心低落和兴趣丧失分别是亚洲男性和女性抑郁症的主要症状。男性的网络连接更具局部性，而女性的网络则更多样化。在所分析的亚洲亚组中，只有东亚人在网络结构上表现出显著差异。男性中神经植物症状的显著影响可能表明东亚人群抑郁症存在潜在的神经生物学基础。
