Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Symptom Clusters’ Links to Psychiatric Disorders

JAMA Psychiatry; ePub 2017 Dec 3; Grisanzio, et al

A recent study offers a data-driven framework for identifying robust subtypes that signify specific, coherent, and meaningful associations between symptoms, behavior, brain function, and observable real-world function, and that cut across DSM-IV-defined diagnoses of major depressive disorder (MDD), panic disorder, and posttraumatic stress disorder (PTSD). This cross-sectional study included 420 individuals with a primary diagnosis of MDD (n=100), panic disorder (n=53), PTSD (n=47), or no disorder (healthy controls) (n=220). Data were analyzed between October 2016 and October 2017. Participants had a mean (SD) age of 39.8 (14.1) years in the final analysis; 256 (61.0%) were female. Researchers found:

  • 6 distinct subtypes characterized by tension (n=81; 19%), anxious arousal (n=55; 13%), general anxiety (n=38; 9%), anhedonia (n=29; 7%), melancholia (n=37; 9%), and normative mood (n=180; 43%) were identified, and these subtypes were replicated in an independent sample.
  • Subtypes were expressed through differences in cognitive control, working memory, electroencephalography-recorded β power in a resting paradigm, electroencephalography-recorded β power in an emotional paradigm, social functional capacity, and emotional resilience.


Grisanzio KA, Goldstein-Piekarski AN, Wang MY, Ahmed APR, Samara Z, Williams LM. Transdiagnostic symptom clusters and associations with brain, behavior, and daily function in mood, anxiety, and trauma disorders. [Published online ahead of print December 3, 2017]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.3951.

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