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Symptom network density does not predict adolescent depression treatment response

Higher network strength was not strongly associated with poorer outcomes among adolescents with depression, according to recent findings.

“One in four adolescents with depression does not respond favorably to treatment. Prognostic markers to identify this nonresponder group are lacking and urgently needed. It has been suggested that the network structure of depressive symptoms (ie, group-level covariance or connectivity between symptoms) may be informative in this regard,” Lizanne Schweren, PhD, of University of Cambridge, and colleagues wrote.

To determine if network characteristics at baseline were predicative of long-term outcomes in adolescents with depression, researchers administered the 33-item Mood and Feelings Questionnaire (MFQ) to 465 adolescents with depression, aged 11 to 17 years. Study participants completed the MFQ prior to psychological treatment and on a regular basis for up to 12 months after treatment end. To establish two equally sized groups, relatedly good and poor responders were distinguished by median percentage change of MFQ summary score between baseline and final follow-up.

Good responders had higher mean MFQ summary scores at baseline (47.5 vs. 44.3) and higher mean levels of suicidality (1.25 vs 1), compared with poor responders.

Global network strength was higher in poor responders; however, the difference was not significant (4.3 vs. 3.6).

Local node strength did not differ between groups, except for “concentration problems,” which was more connected to other nodes in poor responders than good responders at an uncorrected level (2 vs 1.1).

Sensitivity analyses indicated comparable findings when treatment response was defined as below clinical threshold, MFQ scores lower than 27, at final follow-up.

“With network analyses taking an astonishing flight in psychiatry, we recommend cautious application of group-level network density as a prognostic marker. Crucial steps to be taken by the field include further replication studies as well as in-depth psychometric evaluation of the reliability and clinical correlates of network parameters,” the researchers concluded. – by Amanda Oldt

Disclosures: Schweren reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.