Psychiatry Investig.  2021 Jan;18(1):48-58. 10.30773/pi.2020.0367.

Network Analysis of the Symptoms of Depressive Disorders Over the Course of Therapy: Changes in Centrality Measures

Affiliations
  • 1Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
  • 2Department of Psychiatry, Hanyang University School of Medicine, Seoul, Republic of Korea
  • 3Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of Korea
  • 4Department of Psychiatry, The Catholic University of Korea, Yeouido St. Mary’s Hospital, Seoul, Republic of Korea
  • 5Department of Psychiatry, Keimyung University School of Medicine, Daegu, Republic of Korea
  • 6Department of Counselling Psychology, Honam Unviersity College of Humanities and Social Sciences, Gwangju, Republic of Korea
  • 7Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
  • 8Department of Preventive Medicine, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
  • 9Department of Psychiatry, Korea University Anam Hospital, Seoul, Republic of Korea
  • 10Department of Psychiatry, Chonnam National University School of Medicine, Gwangju, Republic of Korea
  • 11Department of Neuropsychiatry, Hanyang University Guri Hospital, Guri, Republic of Korea

Abstract


Objective
Network analysis can be used in terms of a novel psychopathological approach for depressive syndrome. We aimed to estimate the successive network structures of depressive symptoms in patients with depressive disorder using data from the Clinical Research Center for Depression study.
Methods
We enrolled 1,152 South Korean adult patients with depressive disorders who were beginning treatment for first-onset or recurrent depressive episodes. We examined the network structure of the severities of the items on the Hamilton Depression Rating Scale (HAMD) at baseline and at weeks 2, 12, 25, and 52. The node strength centrality of all the HAMD items at baseline and at week 2, 12, 25, and 52 in terms of network analysis.
Results
In the severity networks, the anxiety (psychic) item was the most centrally situated in the initial period (baseline and week 2), while loss of weight was the most centrally situated item in the later period (weeks 25 and 52). In addition, the number of strong edges (i.e., edges representing strong correlations) increased in the late period compared to the initial period.
Conclusion
Our findings support a period-specific and symptom-focused therapeutic approach that can provide complementary information to the unidimensional total HAMD score.

Keyword

Anxiety (psychic), Centrality, Depressive disorders, Network analysis, Symptom-focused approach
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