Heterogeneity in the co-occurrence of depression and anxiety among adolescents: Results of latent profile analysis

Yuelian Dai; Ya Zheng; Kesong Hu; Jingyan Chen; Shan Lu; Qi Li; Jing Xiao

doi:10.1016/j.jad.2024.04.065

Heterogeneity in the co-occurrence of depression and anxiety among adolescents: Results of latent profile analysis

J Affect Disord. 2024 Apr 25:357:77-84. doi: 10.1016/j.jad.2024.04.065. Online ahead of print.

Authors

Yuelian Dai¹, Ya Zheng², Kesong Hu³, Jingyan Chen¹, Shan Lu⁴, Qi Li⁵, Jing Xiao⁶

Affiliations

¹ Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing, China.
² Department of Psychology, Guangzhou University, Guangzhou, China.
³ Department of Psychological Science, University of Arkansas, Little Rock, AR, USA.
⁴ Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing, China; Center for Child Development, Capital Normal University, Beijing 100048, China. Electronic address: lushan79@163.com.
⁵ Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing, China. Electronic address: 6893@cnu.edu.cn.
⁶ Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing, China. Electronic address: xiaojingcnu@163.com.

PMID: 38670464
DOI: 10.1016/j.jad.2024.04.065

Abstract

Background: Depression and anxiety co-occur frequently and there is heterogeneity in the co-occurrence of such symptoms; however, few previous studies investigated the heterogeneity based on person-centered perspectives in adolescents. The primary aim of our study was to explore it using latent profile analysis (LPA), a person-centered statistical approach.

Method: The Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to examine depression and anxiety symptoms in 7422 Chinese adolescents from 23 primary and secondary schools. To investigate latent profiles and assess profile validity, we employed Latent Profile Analysis (LPA), multinomial logistic regression, and analysis of variance.

Results: A three-profile model was suggested as the optimum: low (69.9 %), moderate (21.6 %), and high depression/anxiety (8.5 %). Female with higher negative cognitive bias and higher emotional regulation difficulty are more likely to be categorized in the high depression/anxiety group. Internet addiction, academic "Lying flat" and involution are significantly and positively linked with the severity of anxiety and depression.

Limitations: Reliance on self-reported measures may lead to response bias; the cross-sectional design limits our ability to study how symptom profiles and category membership change over time.

Conclusions: Three latent profiles of the co-occurrence of depression and anxiety presented a parallel pattern, which serves as a poignant reminder of the imperative need to identify Chinese adolescents who may be at elevated risk for depression and/or anxiety, and promoting intervention that are meticulously tailored to address the unique symptom presentations of each individual.

Keywords: Adolescents; Anxiety; Depression; Heterogeneity; LPA.