TY - JOUR
T1 - Bridging Anxiety and Depression
T2 - A Network Approach in Anxious Adolescents: Anxiety-Depression Network
AU - Dobson, Eric T.
AU - Croarkin, Paul E.
AU - Schroeder, Heidi K.
AU - Varney, Sara T.
AU - Mossman, Sarah A.
AU - Cecil, Kim
AU - Strawn, Jeffrey R.
N1 - Funding Information:
This work was supported by the National Institute of Mental Health (K23 MH106037, JRS), the National Institute of Child Health and Development (R01 HD098757, JRS), and the National Institute of Environmental Health Sciences (R01 ES027224, KMC).
Funding Information:
Dr. Dobson has received support from the American Academy of Child & Adolescent Psychiatry (Campaign for America's Kids). Dr. Strawn has received research support from Allergan, Neuronetics, Lundbeck, Otsuka and the National Institutes of Health. He receives royalties from Springer Publishing for two texts and has received material support from Myriad. He has also provided consultation to Myriad and to Intra-cellular Therapeutics. Dr. Croarkin has received research grant support from the National Institute of Mental Health, Brain and Behavior Research Foundation, and Pfizer, Inc.; equipment support from Neuronetics, Inc.; and has received supplies and genotyping services from Assurex Health, Inc. for investigator-initiated studies. He is the primary investigator for a multicenter study funded by Neuronetics, Inc. and a site primary investigator for a study funded by NeoSync, Inc., and he has served as a consultant for Procter & Gamble Company and Myriad Neuroscience. The views expressed within this article represent those of the authors and are not intended to represent the position of NIMH, NICHD, the National Institutes of Health (NIH), or the Department of Health and Human Services.
Funding Information:
The authors thank the patients and their families for participating in this study and the Data Safety Monitoring Board for their oversight of the study. Additionally, we thank the MR technologists from the Imaging Research Center at Cincinnati Children's Hospital Medical Center and Blaise V. Jones, MD, Chief of Neuroradiology, Cincinnati Children's Hospital Medical Center for his over-read of the patients? neuroimaging.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - Background: The phenomenology and neurobiology of depressive symptoms in anxious youth is poorly understood. Methods: Association networks of anxiety and depressive symptoms were developed in adolescents with generalized anxiety disorder (GAD; N=52, mean age: 15.4±1.6 years) who had not yet developed major depressive disorder. Community analyses were used to create consensus clusters of depressive and anxiety symptoms and to identify “bridge” symptoms between the clusters. In a subset of this sample (n=39), correlations between cortical thickness and depressive symptom severity was examined. Results: Ten symptoms clustered into an anxious community, 5 clustered into a depressive community and 5 bridged the two communities: impaired schoolwork, excessive weeping, low self-esteem, disturbed appetite, and physical symptoms of depression. Patients with more depressive cluster burden had altered cortical thickness in prefrontal, inferior and medial parietal (e.g., precuneus, supramarginal) regions and had decreases in cortical thickness-age relationships in prefrontal, temporal and parietal cortices. Limitations: Data are cross-sectional and observational. Limited sample size precluded secondary analysis of comorbidities and demographics. Conclusions: In youth with GAD, a sub-set of symptoms not directly related to anxiety bridge anxiety and depression. Youth with greater depressive cluster burden had altered cortical thickness in cortical structures within the default mode and central executive networks. These alternations in cortical thickness may represent a distinct neurostructural fingerprint in anxious youth with early depressive symptoms. Finally, youth with GAD and high depressive symptoms had reduced age-cortical thickness correlations. The emergence of depressive symptoms in early GAD and cortical development may have bidirectional, neurobiological relationships.
AB - Background: The phenomenology and neurobiology of depressive symptoms in anxious youth is poorly understood. Methods: Association networks of anxiety and depressive symptoms were developed in adolescents with generalized anxiety disorder (GAD; N=52, mean age: 15.4±1.6 years) who had not yet developed major depressive disorder. Community analyses were used to create consensus clusters of depressive and anxiety symptoms and to identify “bridge” symptoms between the clusters. In a subset of this sample (n=39), correlations between cortical thickness and depressive symptom severity was examined. Results: Ten symptoms clustered into an anxious community, 5 clustered into a depressive community and 5 bridged the two communities: impaired schoolwork, excessive weeping, low self-esteem, disturbed appetite, and physical symptoms of depression. Patients with more depressive cluster burden had altered cortical thickness in prefrontal, inferior and medial parietal (e.g., precuneus, supramarginal) regions and had decreases in cortical thickness-age relationships in prefrontal, temporal and parietal cortices. Limitations: Data are cross-sectional and observational. Limited sample size precluded secondary analysis of comorbidities and demographics. Conclusions: In youth with GAD, a sub-set of symptoms not directly related to anxiety bridge anxiety and depression. Youth with greater depressive cluster burden had altered cortical thickness in cortical structures within the default mode and central executive networks. These alternations in cortical thickness may represent a distinct neurostructural fingerprint in anxious youth with early depressive symptoms. Finally, youth with GAD and high depressive symptoms had reduced age-cortical thickness correlations. The emergence of depressive symptoms in early GAD and cortical development may have bidirectional, neurobiological relationships.
KW - Adolescent
KW - Depression
KW - Generalized anxiety disorder (GAD)
KW - Network
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U2 - 10.1016/j.jad.2020.11.027
DO - 10.1016/j.jad.2020.11.027
M3 - Article
C2 - 33221716
AN - SCOPUS:85096661240
VL - 280
SP - 305
EP - 314
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -