The Space of Common Psychiatric Disorders in Adolescents: Comorbidity Structure and Individual Latent Liabilities →

A novel way of understanding psychiatric disorders in adolescents is mapping the disorders into a geometric space with a limited number of dimensions and no disorder aligning along one single dimension. In addition, it has also been found that the geometric dimensions are hierarchically organized, allowing for analyses at different levels of the organization. Furthermore, individuals with psychiatric disorders present with a broad range of liabilities, reflecting the diversity of their clinical presentations.

Method
Exploratory factor analyses of data from the National Comorbidity Survey Adolescent Supplement (NCS-A) with the psychiatric diagnoses as indicators were used to identify the latent major psychopathological dimensions. The loadings of the disorders on those dimensions were served as "coordinates" to calculate the Euclidean distances between disorders. The distribution of individuals in the space was based on the latent factor scores reflecting the major psychopathological conditions. 2nd-order factor analysis was also developed to show that these common psychiatric disorders were hierarchically organized.

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The first plot was the one that can be found in the publication, a way of presenting the geometric relationship among the 16 mental disorders occurred in adolescents in a 3D box.In the plot: 1. Major Depressive Episode/Dysthymia; 2. Generalized Anxiety Disorder; 3. Mania/Hypomania; 4. Specific Phobia; 5. Agoraphobia (with/without panic disorder); 6. Social Anxiety Disorder; 7. Panic Disorder; 8. Separation Disorder; 9. Post-traumatic Stress Disorder; 10. Eating Disorder; 11. Attention Deficit Hyperactivity Disorder; 12. Oppositional Defiant Disorder; 13. Conduct Disorder; 14. Drug Use Disorder; 15. Alcohol Use Disorder; 16. Nicotine Dependence. The second plot presents the relationship in a complex (social) network approach: the sizes of the nodes represent the prevalences of the 16 disorders; the distances between each pair of the disorders represent the Euclidean distances calculated based on the factor loadings as coordinates.

Hierarchical structure of common psychiatric disorders: results of 2nd-order factor analysis of the 16 common psychiatric disorders in adolescents - a paper publication version.

Hierarchical structure of common psychiatric disorders: results of 2nd-order factor analysis of the 16 common psychiatric disorders in adolescents - a web clickable version.

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Serotonin Transporter Gene (5-HTT) Variation Impacts on Development of Anxiety and Depression: A Longitudinal Study

The data were extracted from two waves of a longitudinal study.  The two waves had 10 years apart. 

Due to the skewed nature of the outcomes (symptom scores of anxiety and depression), generalized linear models were applied in this study.  In addition, parameters were estimated based on GEE, and least-squared mean results were given to explain the 5-HTT gene effects on the developmental course of anxiety and depression, as well as the interactive effects between 5-HTT gene and early environmental factor (childhood abuse).

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Effects of 5-HTT gene variation on development of depressive symptom severity. 

Results showed that LaLa allele of 5-HTT gene had protective effects on developing anxiety symptoms in both adolescence and early adulthood.  With a childhood physical abuse history, the protective effects of LaLa allele became stronger than other situations of childhood abuse.  Similar to the effects on anxiety symptoms, LaLa allele was also found to have protective effects on developing depressive symptoms in adolescence and early adulthood.  The difference is that the protective effects may not be interactive with childhood abuse. 

Socio-economic Predictors of Treatment Service Utilization for Mental Health and Substance Related Problems among 84,342 Youth and Young Adults (Ages 12 - 25) →

Originally, it was a racial disparity study.

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The bubble plot shows that socio-economic status distributes disproportionally among races.

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So do health status and health service use for mental health and alcohol/drug use problems.

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Results of logistic regression with multinomial outcome (the reference level is no treatment, the 1st level is treatment for MDE, and the 2nd level is treatment for alcohol/drug use problems.  The analysis was carried among a subpopulation with past-year alcohol/drug abuse or dependence.

The odds of being treated for alcohol/drug use problems is lower among those with family income at $20,000 - $39,999, which is 0.72 times of the odds among those with family income ranged from $40,000 to $74,999, even when other factors are held constant.

Insurance factor is related to treatment received after adjusting for confounding factors.  The odds of being treated for MDE among those without any insurance coverage is 0.69 times of the odds among those with other insurance coverage than Medicaid and Medicare.

Persistence of Chronic Major Depression: a National Prospective Study →

The focus of the original paper is to find important risk factors from multiple perspectives related to the persistent course of chronic major depression, including socio-demographic dimension, economic dimension, insurance, family and developmental risks, previous physical, mental and emotional conditions, treatment-seeking patterns, as well as the nature of chronic MDD conditions.

However, a second look of the results, it can be found that insurance status played a major role compared to other socio-economic factors.  Specially, public insurance beneficiaries are more likely to have a persistent course of chronic MDD, compared to private insurance beneficiaries. In addition, in terms of treatment-seeking patterns, patients who had persistent type of chronic MDD increased odds of seeking treatments.  Even though, these patients still persistently developed depressive disorder.  So, it essentially comes a question.  Exactly, what type of treatment can be effective to these patients with persistent chronic MDD?