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Random-mood interpretation of determinants for major depression

Published online by Cambridge University Press:  05 July 2007

KIRSTEN I. KAPTEIN ,
PETER De JONGE ,
JAKOB KORF ,
JAN SPIJKER ,
RON De GRAAF  and
SIEBREN Y. VAN DER WERF
KIRSTEN I. KAPTEIN
Affiliation:
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands
PETER De JONGE
Affiliation:
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, The Netherlands
JAKOB KORF
Affiliation:
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands
JAN SPIJKER
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands De Gelderse Roos, Institute for Mental Health Care, Arnhem, The Netherlands
RON De GRAAF
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
SIEBREN Y. VAN DER WERF*
Affiliation:
Kernfysisch Versneller Instituut, University of Groningen, The Netherlands
*
*Address for correspondence: Siebren Y. van der Werf, Ph.D., Kernfysisch Versneller Instituut, University of Groningen, Zernikelaan 25, 9747AA Groningen, The Netherlands. (Email: vdwerf@kvi.nl)
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Abstract

Background

It has recently been proposed that major depression disorder (MDD) may, in a heterogeneous population-based cohort, be interpreted in terms of a random-mood model. Mood fluctuations are thought to result from stressors that occur randomly in time. We have investigated whether this concept also holds for more homogeneous groups, defined by known determinants for MDD, and whether the model's parameters, susceptibility (Z) and relaxation time (T), may be evaluated and used to differentiate between subcohorts.

Method

From a large epidemiological survey, the Netherlands Mental Health Survey and Incidence Study (NEMESIS), data on the duration of MDD were obtained for subcohorts, based on gender, severity of depression, recurrence and co-morbidity with dysthymia, anxiety and somatic disorder, and were compared with random-mood simulation calculations.

Results

Susceptibility, Z, is empirically found to be proportional to incidence and may be identified with a risk ratio. A second scaling rule states the proportionality of mean duration with the product of Z and T. This Z–T classification proves to be more sensitive than conventional significance tests. Notably for men/women and for co-morbid anxiety, differences are seen that have previously gone unnoticed.

Conclusions

Depression may be conceptualized as a disorder resulting from random-mood fluctuations, the response to which is influenced by a large variety of determinants or risk factors. The model's parameters can be evaluated and may be used in differentiating between risk factor-defined subgroups.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 9 , September 2007 , pp. 1261 - 1271
Copyright
Copyright © Cambridge University Press 2007

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