title: Symptom-based subtypes of depression and their psychosocial correlates: a person-centered approach focusing on the influence of sex.
abstract: BACKGROUND
  Reducing the complexity of major depressive disorder by symptom-based subtypes constitutes the basis of more specific treatments. To date, few studies have empirically derived symptom subtypes separated by sex, although the impact of sex has been widely accepted in depression research.
  
  
  METHODS
  The community-based sample included 373 males and 443 females from the Zurich Program for Sustainable Development of Mental Health Services (ZInEP) manifesting depressive symptoms in the past 12 months. Latent Class Analysis (LCA) was performed separately by sex to extract sex-related depression subtypes. The subtypes were characterized by psychosocial characteristics.
  
  
  RESULTS
  Three similar subtypes were found in both sexes: a severe typical subtype (males: 22.8%; females: 35.7%), a severe atypical subtype (males: 17.4%; females: 22.6%), and a moderate subtype (males: 25.2%; females: 41.8%). In males, two additional subgroups were identified: a severe irritable/angry-rejection sensitive (IARS) subtype (30%) comprising the largest group, and a small psychomotor retarded subtype (4%). Males belonging to the severe typical subtype exhibited the lowest masculine gender role orientation, while females of the typical subtype showed more anxiety disorders. The severe atypical subtype was associated with eating disorders in both sexes and with alcohol/drug abuse/dependence in females. In contrast, alcohol/drug abuse/dependence was associated with the severe IARS subtype in males.
  
  
  CONCLUSIONS
  The study had a cross-sectional design, allowing for no causal inferences.
  
  
  CONCLUSIONS
  This study contributes to a better understanding of sex-related depression subtypes, which can be well distinguished on the basis of symptom profiles. This provides the base for future research investigating the etiopathogenesis and effective treatment of the heterogeneous depression disorder.
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland. Electronic address: stephanie.rodgers@dgsp.uzh.ch.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Rodgers
authors.affiliation: Department of Psychology, University of Zurich, and Department of Psychology, University of Bern, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Grosse Holtforth
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland.
authors.forename: Mario
authors.initials: M
authors.lastname: Müller
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hengartner
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland; Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Brazil.
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland.
authors.forename: Vladeta
authors.initials: V
authors.lastname: Ajdacic-Gross
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D018802:Patient-Centered Care; D012737:Sex Factors; D055815:Young Adult
keywords: Depression; Epidemiology; Latent class analysis; Sex; Subtypes