The network structure of major depressive disorder, generalized anxiety disorder and somatic symptomatology
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Background: Major depressive disorder (MDD) and generalized anxiety disorder (GAD) often co-occur with somatic symptomatology. Little is known about the contributions of individual symptoms to this association and more insight into their relationships could help to identify symptoms that are central in the processes behind the co-occurrence. This study explores associations between individual MDD/GAD symptoms and somatic symptoms by using the network approach. Method: MDD/GAD symptoms were assessed in 2704 participants (mean age 41.7 years, 66.1% female) from the Netherlands Study of Depression and Anxiety using the Inventory of Depressive Symptomatology. Somatic symptoms were assessed with the somatization scale of the Four-Dimensional Symptom Questionnaire. The technique eLasso was used to estimate the network of MDD/GAD and somatic symptoms. Results: The network structure showed numerous associations between MDD/GAD and somatic symptoms. In general, neurovegetative and cognitive/affective MDD/GAD symptoms showed a similar strength of connections to the somatic domain. However, associations varied substantially across individual symptoms. MDD/GAD symptoms with many and strong associations to the somatic domain included anxiety and fatigue, whereas hypersomnia and insomnia showed no connections to somatic symptoms. Among somatic symptoms, excessive perspiration and pressure/tight feeling in chest were associated with the MDD/GAD domain, while muscle pain and tingling in fingers showed only a few weak associations. Conclusions: Individual symptoms show differential associations in the co-occurrence of MDD/GAD with somatic symptomatology. Strongly interconnected symptoms are important in furthering our understanding of the interaction between the symptom domains, and may be valuable targets for future research and treatment.
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Social network analysis has been increasingly used to illustrate psychiatric disorders as causal systems or to clarify the role of symptom overlap in characterizing constellations of psychiatric disorders.
“Social network analysis has been increasingly used to illustrate psychiatric disorders as causal systems (McNally et al., 2015) or to clarify the role of symptom overlap in characterizing constellations of psychiatric disorders (Bekhuis et al., 2016; Bringmann et al., 2015).”
From Syndemics: a theory in search of data or data in search of a theory? (2018) · cites this paper as Bekhuis et al., 2016
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- Authors
- Bekhuis, E., Schoevers, R. A., van Borkulo, C. D., Rosmalen, J. G. M., & Boschloo, L.
- Affiliations
- University Medical Center Groningen (NL)
- Corresponding author
- Bekhuis, E.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2016-08-15
- Volume
- 46
- Issue
- 14
- Pages
- 2989-2998
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2515452075
- Cited by
- 89
- References
- 43
- Citations by year
- 2026: 8 · 2025: 8 · 2024: 11 · 2023: 7 · 2022: 8 · 2021: 15 · 2020: 7 · 2019: 10 · 2018: 8 · 2017: 7
- FWCI
- 11.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion, other-oa)
- UvA-DARE (University of Amsterdam) (submittedVersion, other-oa)
- UvA-DARE (University of Amsterdam) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Universiteit Leiden (10‐000‐1002)
- Vrije Universiteit Amsterdam
- GGZ inGeest
- Rivierduinen
- GGZ Friesland
- GGZ Drenthe
- Nederlands Instituut voor Onderzoek van de Gezondheidszorg (10-000-1002)
- Leids Universitair Medisch Centrum
- Universitair Medisch Centrum Groningen
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- major depressive disorder, generalized anxiety disorder, somatic symptoms, symptom co-occurrence, symptom networks, neurovegetative symptoms, cognitive-affective symptoms, fatigue, anxiety, insomnia, hypersomnia, somatization
- MeSH terms
- Adult, Anxiety Disorders, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Netherlands, Somatoform Disorders, Comorbidity
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