Identifying depression subtypes and investigating their consistency and transitions in a 1-year cohort analysis

PLoS One. 2025 Jan 14;20(1):e0314604. doi: 10.1371/journal.pone.0314604. eCollection 2025.

Abstract

Major depressive disorder (MDD) is defined by an array of symptoms that make it challenging to understand the condition at a population level. Subtyping offers a way to unpick this phenotypic diversity for improved disorder characterisation. We aimed to identify depression subtypes longitudinally using the Inventory of Depressive Symptomatology: Self-Report (IDS-SR). A secondary analysis of a two-year cohort study called Remote Assessment of Disease and Relapse in Major Depressive Disorder (RADAR-MDD), which collected data every three months from patients with a history of recurrent MDD in the United Kingdom, the Netherlands, and Spain (N = 619). We used latent class and latent transition analysis to identify subtypes at baseline, determined their consistency at 6- and 12-month follow-ups, and examined transitions over time. We identified a 4-class solution: (1) severe with appetite decrease, (2) severe with appetite increase, (3) moderate severity and (4) low severity. These same classes were identified at 6- and 12-month follow-ups, and participants tended to remain in the same class over time. We found no statistically significant differences between the two severe subtypes regarding baseline clinical and sociodemographic characteristics. Our findings emphasize severity differences over symptom types, suggesting that current subtyping methods provide insights akin to existing severity measures. When examining transitions, participants were most likely to remain in their respective classes over 1-year, indicating chronicity rather than oscillations in depression severity. Future work recommendations are made.

MeSH terms

  • Adult
  • Cohort Studies
  • Depression / diagnosis
  • Depressive Disorder, Major* / classification
  • Depressive Disorder, Major* / diagnosis
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Self Report
  • Severity of Illness Index
  • Spain
  • United Kingdom / epidemiology

Grants and funding

C.O. is funded by the UK Medical Research Council (MR/N013700/1) and King’s College London member of the MRC Doctoral Training Partnership in Biomedical Sciences. The RADAR-CNS project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115902. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA (www.imi.europa.eu). This communication reflects the views of the RADAR-CNS consortium and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein. This paper represents an independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.