Symptom Patterns of the Occurrence of Depression and Anxiety in a Japanese General Adult Population Sample: A Latent Class Analysis

Huijie Lei; Chong Chen; Kosuke Hagiwara; Ichiro Kusumi; Hajime Tanabe; Takeshi Inoue; Shin Nakagawa

doi:10.3389/fpsyt.2022.808918

Symptom Patterns of the Occurrence of Depression and Anxiety in a Japanese General Adult Population Sample: A Latent Class Analysis

Front Psychiatry. 2022 Feb 8:13:808918. doi: 10.3389/fpsyt.2022.808918. eCollection 2022.

Authors

Huijie Lei¹, Chong Chen¹, Kosuke Hagiwara¹, Ichiro Kusumi², Hajime Tanabe³, Takeshi Inoue⁴, Shin Nakagawa¹

Affiliations

¹ Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.
² Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
³ Faculty of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan.
⁴ Department of Psychiatry, Tokyo Medical University, Tokyo, Japan.

Abstract

Background: Given the high comorbidity and shared risk factors between depression and anxiety, whether they represent theoretically distinct disease entities or are just characteristics of a common negative affect dimension remains debated. Employing a data-driven and person-centered approach, the present study aims to identify meaningful and discrete symptom patterns of the occurrence of depression and anxiety.

Methods: Using data from an adult sample from the Japanese general population (n = 403, including 184 females, age = 42.28 ± 11.87 years), we applied latent class analysis to identify distinct symptom patterns of depression (PHQ-9) and anxiety (STAI Y1). To empirically validate the derived class memberships, we tested the association between the derived classes and personal profiles including childhood experiences, life events, and personality traits.

Results: The best-fitting solution had four distinct symptom patterns or classes. Whereas both Class 1 and 2 had high depression, Class 1 showed high anxiety due to high anxiety-present symptoms (e.g., "I feel nervous") while Class 2 showed moderate anxiety due to few anxiety-absent symptoms (e.g., "I feel calm"). Class 3 manifested mild anxiety symptoms due to lacking responses on anxiety-absent items. Class 4 manifested the least depressive and anxiety-present symptoms as well as the most anxiety-absent symptoms. Importantly, whereas both Class 1 and 2 had higher childhood neglect and reduced reward responsiveness, etc. compared to Class 4 (i.e., the most healthy class), only Class 1 had greater negative affect and reported more negative life events.

Conclusions: To our knowledge, this is the first latent class analysis that examined the symptom patterns of depression and anxiety in Asian subjects. The classes we identified have distinct features that confirm their unique patterns of symptom endorsement. Our findings may provide insights into the etiology of depression, anxiety, and their comorbidity.

Keywords: anxiety; comorbidity; data-driven; depression; latent class analysis; symptom patterns.