Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
2
Issued Date
2025-05-01
Resource Type
ISSN
17383684
eISSN
19763026
Scopus ID
2-s2.0-105007037429
Journal Title
Psychiatry Investigation
Volume
22
Issue
5
Start Page
552
End Page
563
Rights Holder(s)
SCOPUS
Bibliographic Citation
Psychiatry Investigation Vol.22 No.5 (2025) , 552-563
Suggested Citation
Park S.C., Kim K., Park J., Choi S., Lee S., Cho S., Kim E., Si T.M., Kallivayalil R.A., Tanra A.J., Nadoushan A.H.J., Chee K.Y., Javed A., Sim K., Pariwatcharakul P., Kato T.A., Lin S.K., Shinfuku N., Sartorius N. Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3. Psychiatry Investigation Vol.22 No.5 (2025) , 552-563. 563. doi:10.30773/pi.2025.0033 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/110577
Title
Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Author's Affiliation
Pushpagiri Institute of Medical Sciences and Research Centre
Association for the Improvement of Mental Health Programs
Seinan Gakuin University
Singapore Institute of Mental Health
Taipei City Hospital Taiwan
Pakistan Psychiatric Research Centre
Texas Woman's University
Peking University Sixth Hospital
Hasanuddin University
Kangbuk Samsung Hospital
Kuala Lumpur Hospital
Graduate School of Medical Sciences
Ajou University
Hanyang University College of Medicine
Siriraj Hospital
Hanyang University Guri Hospital
School of Medicine (IUMS)
Hanyang University
Chang Gung Memorial Hospital
Association for the Improvement of Mental Health Programs
Seinan Gakuin University
Singapore Institute of Mental Health
Taipei City Hospital Taiwan
Pakistan Psychiatric Research Centre
Texas Woman's University
Peking University Sixth Hospital
Hasanuddin University
Kangbuk Samsung Hospital
Kuala Lumpur Hospital
Graduate School of Medical Sciences
Ajou University
Hanyang University College of Medicine
Siriraj Hospital
Hanyang University Guri Hospital
School of Medicine (IUMS)
Hanyang University
Chang Gung Memorial Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
Objective The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. Methods We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. Results Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). Conclusion This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.