Journal of International Psychiatry

【Abstract】Objective To study the clinical significance of cross-diagnostic cluster analysis of cognitive phenotypes of major depressive disorder (MDD) and bipolar disorder (BD) in adolescents. Methods A total of 335 subjects were enrolled in this study: 84 BD patients, 58 MDD patients, and 193 adolescent healthy controls. Hamilton anxiety (HAMA-14) and depression (HAMD-24) scales, Brief Psychiatric Scale (BPRS) and Young Mania Scale (YMRS) were assessed. Cognitive subtypes were detected by hierarchical clustering. The difference of symptom severity among different subtypes was compared. Results Three cognitive subtypes were detected by hierarchical cluster analysis: subtype 1 was moderately impaired, subtype 2 was severely impaired, and subtype 3 was mildly impaired. The average ARI (response cluster stability) of cognitive 3 subtype was 0.462. Among the three cognitive subtypes, there was significant difference in the proportion of normal people (X2=77.26, P<0.001), but there was no significant difference in the proportion of diseases (bipolar I, II, MDD). The symptoms of anxiety, depression, psychosis and mania in cognitive subtype 3 were less severe than those in cognitive subtype 1 and 2. Conclusion The mild cognitive impairment subtype showed the mildest symptoms of depression, anxiety, mania and psychosis. The cross-diagnostic cluster analysis of multi-disease cognitive phenotypes has certain practical clinical significance in the classification of symptom severity of BD and MDD in adolescent patients, despite of lack of diagnostic specificity.

Adolescent; Bipolar disorder; Major depressive disorder; hierarchical clustering; Cognitive function