Published in

Elsevier, Journal of Psychosomatic Research, (85), p. 55

DOI: 10.1016/j.jpsychores.2016.03.134

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The network structure of depressive, anxiety, and somatic symptoms.

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

Introduction: Depression and anxiety frequently co-occur with somatic symptoms, and this association constitutes a substantial burden to both patients and society. As previous studies have mainly focused on broad psychiatric diagnoses, much is still unclear about the associations between specific symptoms of depression and anxiety and somatic symptoms. More knowledge into the interaction between these symptoms is important, since it may provide essential insights into the etiology of the co-occurrence of depression, anxiety, and somatic symptoms. The current study, therefore, explores symptom pathways underlying the association between depression, anxiety, and somatic symptoms with a novel network analysis technique. Methods: Data were derived from the baseline measurement of the Netherlands Study of Depression and Anxiety (NESDA), comprising 2610 participants (mean age=41.6 years, 65.9% female). Depressive and anxiety symptoms were assessed with specific items of the Inventory of Depressive Symptomatology (IDS) and the subjective subscale of the Beck Anxiety Inventory (BAI). Somatic symptoms were assessed with the somatization scale of the Four-Dimensional Symptom Questionnaire (4DSQ). The novel network analysis technique eLasso, which combines l1-reguralized logistic regression and a Goodness of fit measure, was used to construct a network of depressive, anxiety, and somatic symptoms. Results: The network structure of depressive, anxiety, and somatic symptoms consisted of two clusters of affective (i.e., depressive and anxiety) and somatic symptoms, which were strongly connected via specific symptom pairs. Of all affective symptoms, leaden paralysis showed the strongest associations with somatic symptoms, followed by fear of losing control, and low energy level. Somatic symptoms with the strongest connections to depressive and anxiety symptoms were pressure/tight feeling in chest, palpitations, and dizziness/feeling lightheaded. Discussion: Depressive, anxiety, and somatic symptoms show strong and complex associations. Therapies for patients with depression and/or anxiety as well as somatic symptoms should be directed to symptoms with high relevance in this association. Future studies should focus on incorporation of individual directed networks in psychosomatic care.