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    Can clinical subtypes contribute to genetic studies on major depression? Caldieraro Marco Antonio,Blaya Carolina,Brusius-Facchin Ana Carolina,Kubaski Francyne,Leistner-Segal Sandra,Fleck Marcelo P Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists 10.1177/1039856217726689
    Validity, reliability and prevalence of four 'clinical content' subtypes of depression. Sharpley Christopher F,Bitsika Vicki Behavioural brain research Although depression is often diagnosed via reference to a list of nine criteria which may be used to form a unitary diagnosis, there is significant variation in the content of those nine criteria to justify consideration of four 'clinical content' subtypes of depression based upon differences in symptomatology. Each of those four subtypes has previously been described for their different causes, underlying neurobiological pathways, and treatment requirements. This paper reports on the validity, reliability and prevalence of those four subtypes of depression across three samples of participants. Validity is demonstrated and satisfactory reliability values are reported for each subtype, plus significant correlations between items used to measure each subtype, arguing for the individual homogeneity of each of these four subtypes. Prevalence data indicated that there were significant subtype differences at the sample and individual level, challenging the usage of a single global depression score. These results argue for further consideration of these subtypes when researching depression and in planning individualised treatment regimes. 10.1016/j.bbr.2013.10.032
    Subtypes of treatment-resistant depression determined by a latent class analysis in a Chinese clinical population. Liao Liwei,Wu Zhiguo,Mellor David,Peng Daihui,Zhang Chen,Xu Jingjing,Wang Chenglei,Cui Lvchun,Fang Yiru Journal of affective disorders BACKGROUND:This study aimed to explore subtypes of treatment-resistant depression (TRD). METHODS:Latent class analysis (LCA) was performed on clinical and demographic data collected from 375 patients with TRD. Clinical variables were compared across subtypes. Treatment outcomes across subtypes of TRD were compared separately for those within each subtype with anxiety (those with a HRSD-17 anxiety/somatization factor score ≥ 7) and those without anxiety. LCA subtypes were compared using Cochran's and Mantel-Haenszel χ test, respectively. Unordered multinomial logistic regression was used to assess clinical correlates of TRD subtypes. RESULTS:Three categories were detected: severe depression (66%), moderate depression with anxiety (9%) and mild depression with anxiety/somatization (25%). Gender, age, age at first onset, family monthly income, number of hospitalizations, HRSD-17 and clinical global impression-severity (CGI) scores were significantly different across the three groups. Remission rates were significantly different among anxious cases with severe (43.75%), moderate (22.73%) and mild (26.25%) depression subtypes. Compared to cases in the mild depression group, those in the severe depression group had a greater likelihood of being male, having a later age of first onset, higher numbers of hospitalization, higher HRSD-17 and CGI total scores, and lower family income. Those in the moderate depression group were more likely to be male and have lower family income than those in the mild depression group. LIMITATIONS:Representative bias, relatively small sample size, unbalanced group size and incomplete indicator variables might have a negative effect on the validity and generalization of the findings. CONCLUSIONS:Depression severity could be a basis for subtype classification of patients with TRD. The classification of latent class of TRD observed in our study was similar to the structure found in MDD. Longitudinal research into the stability of the latent structure of TRD across illness course is merited as is research into treatment outcomes for TRD subtypes. 10.1016/j.jad.2019.02.005
    The clinical relevance of qualitatively distinct subtypes of depression. Kessing Lars Vedel,Bukh Jens Drachmann World psychiatry : official journal of the World Psychiatric Association (WPA) 10.1002/wps.20461
    Subtypes in clinical burnout patients enrolled in an employee rehabilitation program: differences in burnout profiles, depression, and recovery/resources-stress balance. Bauernhofer Kathrin,Bassa Daniela,Canazei Markus,Jiménez Paulino,Paechter Manuela,Papousek Ilona,Fink Andreas,Weiss Elisabeth M BMC psychiatry BACKGROUND:Burnout is generally perceived a unified disorder with homogeneous symptomatology across people (exhaustion, cynicism, and reduced professional efficacy). However, increasing evidence points to intra-individual patterns of burnout symptoms in non-clinical samples such as students, athletes, healthy, and burned-out employees. Different burnout subtypes might therefore exist. Yet, burnout subtypes based on burnout profiles have hardly been explored in clinical patients, and the samples investigated in previous studies were rather heterogeneous including patients with various physical, psychological, and social limitations, symptoms, and disabilities. Therefore, the aim of this study is to explore burnout subtypes based on burnout profiles in clinically diagnosed burnout patients enrolled in an employee rehabilitation program, and to investigate whether the subtypes differ in depression, recovery/resources-stress balance, and sociodemographic characteristics. METHODS:One hundred three patients (66 women, 37 men) with a clinical burnout diagnosis, who were enrolled in a 5 week employee rehabilitation program in two specialized psychosomatic clinics in Austria, completed a series of questionnaires including the Maslach Burnout Inventory - General Survey (MBI-GS), the Beck Depression Inventory, and the Recovery-Stress-Questionnaire for Work. Cluster analyses with the three MBI-GS subscales as clustering variables were used to identify the burnout subtypes. Subsequent multivariate/univariate analysis of variance and Pearson chi-square tests were performed to investigate differences in depression, recovery/resources-stress balance, and sociodemographic characteristics. RESULTS:Three different burnout subtypes were discovered: the exhausted subtype, the exhausted/cynical subtype, and the burned-out subtype. The burned-out subtype and the exhausted/cynical subtype showed both more severe depression symptoms and a worse recovery/resources-stress balance than the exhausted subtype. Furthermore, the burned-out subtype was more depressed than the exhausted/cynical subtype, but no difference was observed between these two subtypes with regard to perceived stress, recovery, and resources. Sociodemographic characteristics were not associated with the subtypes. CONCLUSIONS:The present study indicates that there are different subtypes in clinical burnout patients (exhausted, exhausted/cynical, and burned-out), which might represent patients at different developmental stages in the burnout cycle. Future studies need to replicate the current findings, investigate the stability of the symptom patterns, and examine the efficacy of rehabilitation interventions in different subtypes. 10.1186/s12888-018-1589-y