1, 2 Thus, the heterogeneity of depressive syndrome can be criticized in terms of Wittgenstein's ‘game’ analogy as follows: Whereas cases of depressive syndrome are not commonly underpinned with an ‘essence,’ they are connected by the ‘family resemblance,’ which denotes extensions of meaning. The heterogeneity of depressive syndrome can be due to the polythetic and operational definition of ‘depressive syndrome’ from the viewpoint of a categorical approach rather than a dimensional approach.
Furthermore, our findings suggested that cultural influences related to geographic and economic distributions of participants could influence the estimated depressive symptom network in Asian patients with depressive disorders. Our findings demonstrated that the typical symptoms of the ICD-10 diagnostic criteria for depressive episode are the most centrally situated within the network of depressive symptoms. Geographic and economic variations in networks of depressive symptoms were evaluated. A community-detection algorithm estimated that when excluding psychomotor disturbance as an outlier, the other nine symptoms formed the largest clinically meaningful cluster. Persistent sadness, fatigue, and loss of interest were the most centrally situated within the network of depressive symptoms in Asian patients with depressive disorders overall. Moreover, networks were estimated separately among Asian patients from high-income countries and those from middle-income countries. In addition, networks of depressive symptoms were estimated separately among East Asian patients and South or Southeast Asian patients. The node strength centrality of all ICD-10 diagnostic criteria for a depressive episode was estimated using a community-detection algorithm. Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD), the network of the ICD-10 diagnostic criteria for depressive episode was estimated from 1174 Asian patients with depressive disorders.
We aimed to estimate the network structures of depressive symptoms using network analysis and evaluated the geographic regional differences in theses network structures among Asian patients with depressive disorders.
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