The trajectory of depressive symptoms and the association with quality of life and suicidal ideation in patients with major depressive disorder

Abstract Background Major depressive disorder (MDD) is the most prevalent mental health disorder globally. However, the association between depressive symptom trajectories in the early period and subsequent mental health outcomes remains not fully elucidated. This study aimed to delineate the depres...

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Main Authors: Wenjian Lai, Yuhua Liao, Huimin Zhang, Hao Zhao, Yanzi Li, Ruiying Chen, Guangduoji Shi, Yifen Liu, Jiejing Hao, Zehui Li, Wanxin Wang, Roger S. McIntyre, Ciyong Lu, Xue Han
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Language:English
Published: BMC 2025-03-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-06743-1
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author Wenjian Lai
Yuhua Liao
Huimin Zhang
Hao Zhao
Yanzi Li
Ruiying Chen
Guangduoji Shi
Yifen Liu
Jiejing Hao
Zehui Li
Wanxin Wang
Roger S. McIntyre
Ciyong Lu
Xue Han
author_facet Wenjian Lai
Yuhua Liao
Huimin Zhang
Hao Zhao
Yanzi Li
Ruiying Chen
Guangduoji Shi
Yifen Liu
Jiejing Hao
Zehui Li
Wanxin Wang
Roger S. McIntyre
Ciyong Lu
Xue Han
author_sort Wenjian Lai
collection DOAJ
description Abstract Background Major depressive disorder (MDD) is the most prevalent mental health disorder globally. However, the association between depressive symptom trajectories in the early period and subsequent mental health outcomes remains not fully elucidated. This study aimed to delineate the depressive symptom trajectories during the initial phase of treatment, identify baseline characteristics associated with these trajectories, and explore the association of trajectories with subsequent quality of life and suicidal ideation. Methods Participants were from the Depression Cohort in China. The diagnosis of MDD was assessed using the Mini-International Neuropsychiatric Interview (M.I.N.I.). Information on depressive symptom severity, quality of life, suicidal ideation and other demographics were collected. Latent class trajectory modeling was used to identify distinct classes of depressive symptom trajectories. Results A total of 566 patients with MDD were included, and we identified 3 categories with differential trajectories characterized by improving class (66.7%), moderate decreasing class (27.7%), and persistent high class (5.6%). Compared to the improving class, severer anxiety and depressive symptoms at baseline increased the odds of belonging to the moderate decreasing class and persistent high class. Both moderate decreasing class and persistent high class were associated with increased risks of subsequent diminished quality of life. Additionally, only persistent high class was associated with a higher risk of subsequent suicidal ideation. Conclusion Severe baseline anxiety and depressive symptoms identify a subpopulation of persons living with MDD who evince a greater likelihood of symptom worsening over time as well as greater decrements in quality of life and worsening measures of suicidality.
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spelling doaj-art-d37e103072d940d89bc3440b50fc7f062025-08-20T03:07:44ZengBMCBMC Psychiatry1471-244X2025-03-0125111210.1186/s12888-025-06743-1The trajectory of depressive symptoms and the association with quality of life and suicidal ideation in patients with major depressive disorderWenjian Lai0Yuhua Liao1Huimin Zhang2Hao Zhao3Yanzi Li4Ruiying Chen5Guangduoji Shi6Yifen Liu7Jiejing Hao8Zehui Li9Wanxin Wang10Roger S. McIntyre11Ciyong Lu12Xue Han13Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen UniversityDepartment of Psychiatry, Shenzhen Nanshan Center for Chronic Disease ControlDepartment of Psychiatry, Shenzhen Nanshan Center for Chronic Disease ControlDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen UniversityDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen UniversityDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen UniversityDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen UniversityDepartment of Psychiatry, Shenzhen Nanshan Center for Chronic Disease ControlDepartment of Psychiatry, Shenzhen Nanshan Center for Chronic Disease ControlDepartment of Psychiatry, Shenzhen Nanshan Center for Chronic Disease ControlDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen UniversityDepartment of Psychiatry, University of TorontoDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen UniversityDepartment of Psychiatry, Shenzhen Nanshan Center for Chronic Disease ControlAbstract Background Major depressive disorder (MDD) is the most prevalent mental health disorder globally. However, the association between depressive symptom trajectories in the early period and subsequent mental health outcomes remains not fully elucidated. This study aimed to delineate the depressive symptom trajectories during the initial phase of treatment, identify baseline characteristics associated with these trajectories, and explore the association of trajectories with subsequent quality of life and suicidal ideation. Methods Participants were from the Depression Cohort in China. The diagnosis of MDD was assessed using the Mini-International Neuropsychiatric Interview (M.I.N.I.). Information on depressive symptom severity, quality of life, suicidal ideation and other demographics were collected. Latent class trajectory modeling was used to identify distinct classes of depressive symptom trajectories. Results A total of 566 patients with MDD were included, and we identified 3 categories with differential trajectories characterized by improving class (66.7%), moderate decreasing class (27.7%), and persistent high class (5.6%). Compared to the improving class, severer anxiety and depressive symptoms at baseline increased the odds of belonging to the moderate decreasing class and persistent high class. Both moderate decreasing class and persistent high class were associated with increased risks of subsequent diminished quality of life. Additionally, only persistent high class was associated with a higher risk of subsequent suicidal ideation. Conclusion Severe baseline anxiety and depressive symptoms identify a subpopulation of persons living with MDD who evince a greater likelihood of symptom worsening over time as well as greater decrements in quality of life and worsening measures of suicidality.https://doi.org/10.1186/s12888-025-06743-1Major depressive disorderSymptom trajectoryQuality of lifeSuicidal ideation
spellingShingle Wenjian Lai
Yuhua Liao
Huimin Zhang
Hao Zhao
Yanzi Li
Ruiying Chen
Guangduoji Shi
Yifen Liu
Jiejing Hao
Zehui Li
Wanxin Wang
Roger S. McIntyre
Ciyong Lu
Xue Han
The trajectory of depressive symptoms and the association with quality of life and suicidal ideation in patients with major depressive disorder
BMC Psychiatry
Major depressive disorder
Symptom trajectory
Quality of life
Suicidal ideation
title The trajectory of depressive symptoms and the association with quality of life and suicidal ideation in patients with major depressive disorder
title_full The trajectory of depressive symptoms and the association with quality of life and suicidal ideation in patients with major depressive disorder
title_fullStr The trajectory of depressive symptoms and the association with quality of life and suicidal ideation in patients with major depressive disorder
title_full_unstemmed The trajectory of depressive symptoms and the association with quality of life and suicidal ideation in patients with major depressive disorder
title_short The trajectory of depressive symptoms and the association with quality of life and suicidal ideation in patients with major depressive disorder
title_sort trajectory of depressive symptoms and the association with quality of life and suicidal ideation in patients with major depressive disorder
topic Major depressive disorder
Symptom trajectory
Quality of life
Suicidal ideation
url https://doi.org/10.1186/s12888-025-06743-1
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