Clinical heterogeneity in major depressive disorder underlies comorbidity with functional disorders, 2025, Thomas

https://www.sciencedirect.com/science/article/abs/pii/S0022395625000640

Highlights:

• Among MDD cases, most, but not all, MDD symptoms are uniquely associated with functional disorders suggesting that some features of MDD are particularly important to the comorbidity between MDD and FDs.
• Functional disorders are more common among MDD cases with symptom subtypes defined by (1) increased severity and (2) the presence of anhedonia and increased weight/appetite.
• The comorbidity between MDD and FDs does not appear to be the result of a single mechanism, varying quantitatively as a function of severity and qualitatively as a function of the presence of particular symptoms.

Abstract

The comorbidities between MDD and functional disorders (FDs), such as fibromyalgia (FM), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and irritable bowel syndrome (IBS) remain largely unexplored.

We analyzed data from 10,563 lifetime MDD cases (mean age=50.5 (SD=11.9), 71.8% female) from the Lifelines Cohort Study.

Lifetime MDD symptoms from DSM-5 criterion A were assessed in 2018.

Current FDs were assessed according to diagnostic criteria between 2014-2017.

First, we modeled the effect of 12 disaggregated MDD symptoms on FM, ME/CFS, and IBS diagnoses using multiple logistic regression.

Most, but not all, MDD symptoms were associated with FD diagnoses, suggesting that some features of MDD are particularly important to the comorbidity between MDD and FDs.

Next, we used Latent Class Analysis to classify MDD cases based on their symptoms to explore whether MDD – FD comorbidities were associated with specific symptom profiles.

We found that a five-class solution provided the best balance of model fit and entropy.

Two classes, termed severe typical and anhedonia/weight gain, associated with increased prevalence of all FDs.

The severe typical class was equally associated with FM and ME/CFS, while the anhedonia/weight gain class was differentially associated with pairs of FDs suggesting that features of the anhedonia/weight gain class are uniquely related to different FDs with varying magnitudes of effect and, possibly, different mechanisms.

The comorbidity between MDD and FDs does not appear to result from a single mechanism.

Identification of the mechanisms that underlie the association between MDD and FDs is a priority for future work.

 

Give us more money!

 

They should honestly just go back to ghosts and demons and so on. It's not as if it makes any difference here.

They take the most common generic symptoms around, and find that they are common and generic, especially among conditions featuring only generic non-specific symptoms. Good for you, have a cookie, or whatever.

 

Have they actually managed to try and use the word ‘entropy’ in justifying this?!:

this does feel like an even more convoluted version of pulling the which cup is the ball under trick

hoping no one can be arsed to keep up with some tourturing of stat twists as if they made sense to try and claim proof one now underlies the other

when they haven’t done the basics of clarifying the datasets they began with were accurate and solid given eg depression has been a common misdiagnosis by those who weren’t educated on me/cfs in the past , and the ‘FDs’ are only by their assertion those 3conditions are apparently functional

these were diagnoses from 2014-17, and given even the IOM report only came out in 2015 and the CDC update to me/cfs 2018 should they not have been confirming the definition used at the time?

And importantly isn’t there a massive potential for an overarching causal factor for any ‘correlations’ which is that GET+CBT harmed both the physical illness and mental injury from gaslighting ‘treatment’ - which places the cause not with anything either emotional or psychiatric but with the maltreatment via situational and direct application of inappropriate unkindness (which is what telling someone their illness is flase beliefs - it’s like ten times worse when it’s your own body someone is gaslighting vs the situation it was thought serious and injuries enough that a film was made about it) and over exertion on a body that harmed , stripping it if its ability to cope. Ie creating a desperate situation by design by forcing a body to be beyond its limits if harms and taking away any hope of safety to stop those harms without being called deluded

I don’t quite understand how someone can produce something like this these days without these facts and a lot of soul searching of what was done and how it is an injury, not a ‘pathology’ ?

 

“The severe typical class was equally associated with FM and ME/CFS, while the anhedonia/weight gain class was differentially associated with pairs of FDs suggesting that features of the anhedonia/weight gain class are uniquely related to different FDs with varying magnitudes of effect and, possibly, different mechanisms.”

How on Earth can someone keep their title and respect whilst hedging their bets in a contrived snd extrapolated ‘association’ that is so tenuous they aren’t even saying correlated, are using a slash between 2 different conditions as if weight gain and a hedonism were the same thing and then saying ‘that’ (whatever it is?) was ‘differentially associated with’ - a nonsense term - ‘pairs’ of FDs , so I assume they couldn’t find even on these tortured rephrase what counts as reporting words they couldn’t find anything until they paired the illnesses up in a certain way

are they bare-faced not embarrassed that this tiptoe non-finding was the best pips they could squeeze out if a very selective 3yrs of data they sliced and diced to extremes ?

 

Ahh well there is one name I now recognise who is a co-author: Rosmalen

 

https://virology.ws/2023/04/26/tria...rosmalen-professor-of-psychosomatic-medicine/

 

"The existence of comorbidity between MDD and functional disorders (FDs), such as fibromyalgia (FM), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and irritable bowel syndrome (IBS), is well established in the literature (Chang et al., 2015; Clark et al., 2011; Koloski et al., 2012; Yepez et al., 2022). However, few studies have assessed whether individuals with particular subtypes of MDD are more likely to suffer from FDs. Previous studies report that features of atypical depression occur more frequently among FM and ME/CFS cases compared to other features of depression (McInnis et al., 2014; Ross et al., 2010). Unfortunately, small sample sizes limit the conclusions that can be drawn from these analyses."