{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T13:35:14Z","timestamp":1777296914111,"version":"3.51.4"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"15","license":[{"start":{"date-parts":[[2014,4,9]],"date-time":"2014-04-09T00:00:00Z","timestamp":1397001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec id=\"S0033291714000749_sec_a1\"><jats:title>Background.<\/jats:title><jats:p>Despite substantial research, uncertainty remains about the clinical and etiological heterogeneity of major depression (MD). Can meaningful and valid subtypes be identified and would they be stable cross-culturally?<\/jats:p><\/jats:sec><jats:sec id=\"S0033291714000749_sec_a2\" sec-type=\"methods\"><jats:title>Method.<\/jats:title><jats:p>Symptoms at their lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age \u2a7e30 years, with recurrent DSM-IV MD. Latent class analysis (LCA) was performed in Mplus.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291714000749_sec_a3\" sec-type=\"results\"><jats:title>Results.<\/jats:title><jats:p>Using the nine DSM-IV MD symptomatic A criteria, the 14 disaggregated DSM-IV criteria and all independently assessed depressive symptoms (<jats:italic>n<\/jats:italic>\u00a0=\u00a027), the best LCA model identified respectively three, four and six classes. A severe and non-suicidal class was seen in all solutions, as was a mild\/moderate subtype. An atypical class emerged once bidirectional neurovegetative symptoms were included. The non-suicidal class demonstrated low levels of worthlessness\/guilt and hopelessness. Patterns of co-morbidity, family history, personality, environmental precipitants, recurrence and body mass index (BMI) differed meaningfully across subtypes, with the atypical class standing out as particularly distinct.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291714000749_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusions.<\/jats:title><jats:p>MD is a clinically complex syndrome with several detectable subtypes with distinct clinical and demographic correlates. Three subtypes were most consistently identified in our analyses: severe, atypical and non-suicidal. Severe and atypical MD have been identified in multiple prior studies in samples of European ethnicity. Our non-suicidal subtype, with low levels of guilt and hopelessness, may represent a pathoplastic variant reflecting Chinese cultural influences.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291714000749","type":"journal-article","created":{"date-parts":[[2014,4,9]],"date-time":"2014-04-09T12:55:24Z","timestamp":1397048124000},"page":"3275-3288","source":"Crossref","is-referenced-by-count":52,"title":["Subtypes of major depression: latent class analysis in depressed Han Chinese 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