Subgroups of sex and race/ethnicity do not share the same latent construct for symptoms of anxiety and depression, according to research published in the Journal of Psychiatric Research.

In this epidemiologic study, researchers used data from the National Epidemic Survey on Alcohol and Related Conditions to identify the heterogeneity of comorbid mood and anxiety symptomatology and compared the latent class structure across sex and race/ethnic groups in order to determine group differences in these latent class configurations.

The nationwide survey included 43,093 participants (average age 46.40) who were mostly women (57%), white (56.9%), and born in the United States (82.7%). Researchers evaluated survey answers for symptoms of Major Depressive Disorder, Dysthymic Disorder, Generalized Anxiety Disorder and Panic Disorder. They then used latent class analyses with maximum likelihood estimation to assess latent subgroups of symptoms that characterize the population.

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For the total sample, researchers identified 6 subtypes of mood and anxiety symptoms, plus a “healthy” subgroup defined by an absence of symptoms. While men best fit the 7-class model, it was discovered that on average women were better suited for an 11-class model, suggesting a greater variation in how anxiety and depression manifest in women than men.

In addition, non-Hispanic white and black subgroups were best suited for the same 7-class model as all men, while a 5-class model was the best fit for Hispanics, and a 4-class model was best for the Asian and American Indian subgroups.

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The researchers noted a few limitations to their study, such as the inability to verify the stability of the latent classes over time due to the cross-sectional nature of the data.

Despite these limitations, researchers said their findings “confirm that there is great heterogeneity in how mood and anxiety symptoms manifest across groups. While there are limited epidemiologic data to date examining comorbid symptom manifestation across subpopulations, there is sufficient evidence to suggest that physiology and culture underlie some of the variation in how depression and anxiety symptoms can manifest.”


Rudenstine S, Espinosa A. Latent comorbid depression and anxiety symptoms across sex and race/ethnic subgroupings in a national epidemiologic study [published online July 17, 2018] Journal of Psychiatric Research. doi:10.1016/j.jpsychires.2018.07.005