Alan R Teo1, Sarah Nelson2, Wynn Strange2, Hiroaki Kubo3, Ryoko Katsuki3, Keita Kurahara3, Shigenobu Kanba3, Takahiro A Kato4. 1. VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), 3710 SW US Veterans Hospital Rd (R&D 66), Portland, OR 97239-2964, USA; Oregon Health & Science University, Department of Psychiatry, 3181 SW Sam Jackson Park Rd (Multnomah Pavilion, Room 2316), Portland, OR 97239-3098, USA; Oregon Health & Science University and Portland State University, School of Public Health, 506 SW Mill St., Suite 450 (OMPH-SCH), Portland, OR 97201, USA. Electronic address: teoa@ohsu.edu. 2. VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), 3710 SW US Veterans Hospital Rd (R&D 66), Portland, OR 97239-2964, USA. 3. Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan. 4. Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan. Electronic address: takahiro@npsych.med.kyushu-u.ac.jp.
Abstract
BACKGROUND: Social withdrawal is a feature of a number of psychiatric disorders including major depressive disorder (MDD), yet research examining social withdrawal as a feature of MDD is rare. METHODS: This was a retrospective case-control study. Participants (N = 67) were recruited through an outpatient clinic at an academic medical center in Japan. Major depressive disorder (MDD) and social withdrawal were established with the Structured Clinical Interview for DSM-IV Axis I Disorders and a semi-structured psychiatric interview, respectively. Participants also completed self-report measures. RESULTS: We classified 24 participants as cases (MDD with social withdrawal) and 43 participants as controls (MDD without social withdrawal). Cases, on average, were more likely to have lower education level, prior episodes of depression, and higher suicidal ideation at baseline than controls. In unadjusted regression models, cases had significantly less social connection, less reward dependence, less self-directedness, and higher scores on scales of modern-type depression and hikikomori. In adjusted regression models, associations between social withdrawal and hikikomori (p<0.01) and reward dependence (p = 0.03) remained significant. LIMITATIONS: The sample was limited in size and drawn from a single site. CONCLUSIONS: In patients with MDD, social withdrawal may have subtle associations with clinical symptoms, social connection, and personality traits. Developing a better understanding of social withdrawal's phenotype in depression requires more in-depth examination.
BACKGROUND: Social withdrawal is a feature of a number of psychiatric disorders including major depressive disorder (MDD), yet research examining social withdrawal as a feature of MDD is rare. METHODS: This was a retrospective case-control study. Participants (N = 67) were recruited through an outpatient clinic at an academic medical center in Japan. Major depressive disorder (MDD) and social withdrawal were established with the Structured Clinical Interview for DSM-IV Axis I Disorders and a semi-structured psychiatric interview, respectively. Participants also completed self-report measures. RESULTS: We classified 24 participants as cases (MDD with social withdrawal) and 43 participants as controls (MDD without social withdrawal). Cases, on average, were more likely to have lower education level, prior episodes of depression, and higher suicidal ideation at baseline than controls. In unadjusted regression models, cases had significantly less social connection, less reward dependence, less self-directedness, and higher scores on scales of modern-type depression and hikikomori. In adjusted regression models, associations between social withdrawal and hikikomori (p<0.01) and reward dependence (p = 0.03) remained significant. LIMITATIONS: The sample was limited in size and drawn from a single site. CONCLUSIONS: In patients with MDD, social withdrawal may have subtle associations with clinical symptoms, social connection, and personality traits. Developing a better understanding of social withdrawal's phenotype in depression requires more in-depth examination.