Identifying Data-Driven Depression Subtypes Based on Mood and Behavior

older depressed man
A study identified depression subtypes based on mood and behavior as opposed to diagnostic criteria.

In a study of symptom-based depression subtypes, researchers found that harm avoidance, number of lifetime traumatic events, and severity of maltreatment can predict severity of depressive subtypes. The full study was published in the Journal of Affective Disorders.

A total of 417 patients with depressive disorder were recruited from a psychiatry department in a major hospital in Seoul, Korea. Investigators performed a latent profile analysis of 3 higher-order scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF), Korean version. These 3 scales included emotional/internalizing dysfunction, thought dysfunction, and behavioral/externalizing dysfunction.

The 140-item Temperament and Character Inventory-Revised-Short self-report questionnaire was used to assess 4 temperate dimensions: novelty seeking, harm avoidance, reward dependence, and persistence. Additional assessments were made in regard to participants’ recent negative life events, number of lifetime traumatic events, and severity of maltreatment, all of which were used as covariates in a multinomial regression analysis.

The latent profile analysis identified 4 mood classes: a severe mood class (39.8%), moderate mood class (37.4%), mild mood class (11.3%), and severe mood/thought class (11.5%).

Significant predictors of the mild mood class vs the moderate mood class included harm avoidance (odds ratio [OR], 0.94; P =.002) in the temperament dimensions as well as the number of lifetime traumatic events (OR, 0.52; P =.006) and severity of maltreatment (OR, 0.93; P =.000) in negative life experiences.

Additionally, predictors of the moderate mood class vs the severe mood class included harm avoidance (OR, 0.93; P =.000) and persistence (OR, 1.04; P =.004). Childhood maltreatment severity and lifetime traumatic events differentiated severe mood/thought class from the severe mood class.

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A limitation of the higher-order scales for emotionalizing/internalizing dysfunction, thought dysfunction, and behavioral/externalizing dysfunction used in this study was the inclusion of broad and heterogeneous symptoms. Additionally, the study lacked longitudinal data for depression recurrence, duration of depressive episodes, and medications.

“Helping depressive patients to understand and regulate their temperamental characteristics, and dealing with their past traumatic experiences, should be considered essential in treatment,” wrote the researchers.


Choi JY, Gim MS, Lee JY. Predictability of temperaments and negative experiences on higher-order T symptom-based subtypes of depression [published online January 9, 2020]. J Affect Disord. doi: 10.1016/j.jad.2020.01.028