Background

Previous studies stratified patients with major depressive disorder (MDD) based on their clinical characteristics. This study used this approach in individuals with lifetime MDD who reported low wellbeing, a group of high clinical relevance.

Methods

We selected participants in the UK Biobank (UKB) with lifetime MDD and a wellbeing score in the lowest 25 %. A wellbeing score was previously created considering happiness, belief that own life is meaningful, health satisfaction and functioning in relevant areas. In the selected group, we applied latent class analysis using mood-spectrum symptoms and personality traits as input variables, then we compared the clinical-demographic and genetic (polygenic risk scores, PRSs) characteristics of the identified classes.

Results

A total of 13,896 individuals were included and a model with five classes showed the best performance. The most common class (31.25 %) was characterised by periods of irritable mood and trait irritability with high neuroticism. A rarer class (16.49 %) showed depressive-manic mood fluctuations and risk-taking personality, higher percentage of males, atypical depressive symptoms, lower socio-economic status, higher PRS for attention-deficit hyperactivity disorder and lower PRS for education. The second most common class (29.79 %) showed worry as main personality trait with low risk of manic/irritable manifestations. The remaining classes showed an anxious-irritable personality profile and a purely depressive profile (4.92 % and 17.55 %, respectively).

Limitations

Our results may reflect the characteristics of UKB participants.

Conclusions

Subthreshold manic/irritable mood fluctuations and personality traits irritability and neuroticism may distinguish the most common groups with poor wellbeing in lifetime MDD.

中文翻译：

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英国生物银行中患有终生抑郁症和低幸福感的个体的分层

背景

先前的研究根据重度抑郁症 (MDD) 的临床特征对患者进行分层。这项研究在患有终生 MDD 的个体中使用了这种方法，这些个体报告幸福感低下，这是一组具有高度临床相关性的个体。

方法

我们选择了英国生物银行 (UKB) 的终生 MDD 和幸福指数最低 25% 的参与者。之前根据幸福感、对自己的生活有意义的信念、健康满意度和相关领域的功能来创建幸福评分。在选定的组中，我们使用情绪谱症状和人格特质作为输入变量应用潜在类别分析，然后我们比较了已识别类别的临床人口统计学和遗传（多基因风险评分，PRS）特征。

结果

总共包括 13,896 个人，具有五个类别的模型显示出最佳性能。最常见的一类 (31.25 %) 的特点是周期性的易怒情绪和具有高度神经质的易怒特质。一个罕见的类别 (16.49 %) 表现出抑郁-躁狂情绪波动和冒险性格，男性比例较高，非典型抑郁症状，社会经济地位较低，注意力缺陷多动障碍的 PRS 较高，教育 PRS 较低。第二个最常见的类别 (29.79 %) 显示忧虑是主要人格特征，躁狂/易怒表现的风险较低。其余班级表现出焦虑易怒的人格特征和纯粹的抑郁特征（分别为 4.92% 和 17.55%）。

限制

我们的结果可能反映了 UKB 参与者的特征。

结论

亚阈值躁狂/易怒情绪波动和人格特质易怒和神经质可能会区分一生中幸福感较差的最常见 MDD 人群。