The heterogeneous pool of depressive disorder: Disentangling homogeneous subtypes
12 / 2009 - unknown
Major depressive disorder is a widely recognized public health issue, and well on its way to becoming the leading cause of burden of disease. Although depressive states have been reported as early as the days of Hippocrates, heterogeneity of depression is still an issue in psychiatry and empirically validated subtypes and their etiologic pathways are largely lacking. Data-driven techniques like latent class and latent growth curve analyses that cluster persons based on specific depressive symptoms are highly appealing, because of their ability to identify empirically valid subtypes. I previously confirmed the existence of an atypical subtype that showed considerable associations with metabolic abnormalities, which will be followed-up on in the proposed research. Further, using longitudinal data, depressive course trajectories and their determinants will be evaluated using latent growth curve analysis. This research gives new insights into different etiologic pathways and depression course and outcome, which can be a first step in the development of improved treatment strategies. To conduct the proposed research, I will spend two years at Dr. Merikangas' research group at the US National Institute of Mental Health, Bethesda. This group has tremendous experience in psychiatric epidemiology and will provide me access to several large, high-quality study cohorts.