Longitudinal symptom-based clinical profiles in depressed individuals linked to salience network: findings from the Texas resilience against depression study.

BACKGROUND

Anxious depression is characterized by an earlier onset of symptoms and severity. A systematic assessment of symptoms over time and identification of clinical and neural circuit dysfunction associated with longitudinal symptom profiles may provide a better understanding of the pathophysiology of anxious depression.

METHODS

The D2K arm of the Texas Resilience Against Depression (T-RAD) study (NCT02919280) participants, 10 years or older, with a current or a past diagnosis of depression, were included. For the longitudinal clinical symptom profile analysis, clinical discriminant analysis, and neuroimaging discriminant analysis, 892 participants with at least two in-person visits or two remote batteries of assessments, 415 participants with depression, and 274 participants with resting-state functional magnetic resonance imaging (MRI) and structural MRI data at baseline were included, respectively.

RESULTS

The cohort was 71 % female, 76 % white, and 84 % non-Hispanic and completed 6 in-person visits and 23 remote visits on average. Symptom profile analysis assigned participants with a consistent longitudinal profile (>90 % of visits) to categories as follows: 407 DEP + ANX (46 %), 117 with no symptoms (13 %), 23 DEP only (3 %), and 11 ANX only (1 %) and those with an inconsistent longitudinal profile as UNSTABLE (n = 334, 37 %). Reduced levels of activity and pleasure in engaging in hobbies/activities and higher levels of irritability, emotional abuse, and neglect, and salience network hypoconnectivity were related to DEP + ANX.

CONCLUSION

We developed a categorical tool to assign participants to symptom-based clinical groups. Salience network hypoconnectivity was associated with persistent anxiety and depressive symptoms.