У подростков с депрессией выявлены уникальные группы симптомов, зависящие от травм и тревожности

Youth with depression or suicidality may have distinct symptom profiles associated with differences in trauma history, interpersonal safety, anxiety, suicidality, and resilience, according to study findings published in the Journal of Child Psychology and Psychiatry. Researchers aimed to characterize patterns of depressive symptoms and the association with demographic, clinical, and social factors. Using the Texas Youth Depression and Suicide Research Network (TX-YDSRN), researchers selected eligible participants who were aged 8 to 20 years. Additionally, participants had depression, reported suicidal thoughts or behaviors (STBs), or were receiving treatment for depression. Changes in clinical outcomes were assessed at 1-, 2-, 4-, and 6-months. The Somatic Symptoms group was characterized primarily by sleep problems, appetite or weight changes, low energy, and difficulty concentrating, with less prominent depressed mood and suicidal ideation. [T]his study highlights the heterogeneity of depressive symptom presentations among treatment-seeking youth by identifying distinct latent classes with unique clinical and social-ecological profiles. Depression was defined as a score of 3 or more on the Patient Health Questionnaire-2 (PHQ-2) or 10 or more on the Patient Health Questionnaire-9 modified for Adolescents (PHQ-A). Researchers used individual responses on the Patient Health Questionnaire for Adolescents (PHQ-A), while STBs were measured using the PHQ-A item 9 or Concise Health Risk Tracking Scale-Self-Report (CHRT-SR). to group participants according to patterns of depressive symptoms. To assess anxiety symptoms, lifetime exposure to traumatic events, obstacles to treatment, social needs, ability to adapt/recovery from stress were measured using the Generalized Anxiety Disorder Scale-7 Items (GAD-7), the Traumatic Events Screening Inventory for Children (TESI-C), the Barriers to Treatment Participation Scale (BTPS), the Accountable Health Communities Screening Tool (AHC), and the Connor-Davidson Resilience Scale 10-Item (CD-RISC-10). A total of 1825 participants (mean age, 15.64 years; 72.2% women; 67.8% White) were selected for final analysis. The analysis separated participants into 5 groups: Moderate Symptoms (27.8%), High Symptoms (23.5%), Mild Symptoms (20.5%), Somatic Symptoms (15.6%), and No Symptoms (12.4%). Overall, 65.0% had a history of trauma. Annual household income was less than $50,000 for 40.7% of participants, $50,000 to $100,000 for 26.2%, and more than $100,000 for 33.1% of participants. Sex distribution varied significantly across symptom groups, with women accounting for 77.5% of the High Symptoms group vs 60.7% of the No Symptoms group. Trauma exposure also differed significantly, affecting 72.1% of participants in the High Symptoms group vs 58.0% in the No Symptoms group (both P <.0001). Interpersonal safety concerns were reported by 58.7% of participants in the High Symptoms group, 57.3% in the Somatic Symptoms group, 56.9% in the Moderate Symptoms group, and 56.2% in the Mild Symptoms group vs 44.8% in the No Symptoms group (P =.016). Clinical measures also differed across symptom groups, where the highest mean (SD) PHQ-A scores was in the High Symptoms group at 21.00 (2.96), followed by the Moderate Symptoms group at 14.43 (2.17), Somatic Symptoms group at 12.02 (2.76), Mild Symptoms group at 7.56 (1.98), and No Symptoms group at 2.96 (2.03; P <.0001). Mean anxiety scores ranged across all latent classes, with the highest in the High Symptoms group (mean GAD-7, 15.94) while the No Symptoms group ranked lowest (mean GAD-7, 4.04; P <.0001). Suicidal thoughts/risk and suicidal propensity also varied significantly across groups (P <.0001), with greater suicidality generally accompanying greater depressive symptom severity. Conversely, mean resilience scores were lowest among participants in the High Symptoms group (mean, 16.24) and highest among those in the No Symptoms group (mean, 24.19; P <.0001). Differences in treatment barriers varied by age. Among participants aged 8 to 17 years, the therapist relationship was the only assessed treatment barrier that differed significantly across groups (P =.005). Among those aged 18 to 20 years, significant differences were found for overall treatment barriers and each domain (P ranging <.0001 to .0041), with the greatest barriers generally reported by participants in the High Symptoms group. During the 6-month follow-up, patterns of change in depressive symptoms differed by baseline symptom group (P <.0001), but the magnitude of within- and between-group differences was small (d≤0.208 and d≤0.148, respectively). Significant differences in trajectories were also observed for anxiety (P =.0149), suicidal propensity (P <.0001), and suicidal thoughts/risk (P <.0001), although effect sizes were generally small. Study limitations include the clinical setting of recruitment, assessment of symptom groups only at baseline, and the relatively short 6-month follow-up period. “[T]his study highlights the heterogeneity of depressive symptom presentations among treatment-seeking youth by identifying distinct latent classes with unique clinical and social-ecological profiles,” the study authors concluded. This research was supported by the Texas Youth Depression and Suicide Research Network. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures. References: Lee R, Trent ES, Wagner KM, et al. Latent classes of depressive symptoms among youth: clinical and social determinants of health correlates and longitudinal outcomes. J Child Psychol Psychiatry. Published online August 1, 2026. doi:10.1111/jcpp.70211