Longitudinal association between somatic symptoms and suicidal ideation in adults with major depressive disorder
Bibliographic record
Abstract
Background Major depressive disorder (MDD) is often accompanied by somatic symptoms, but their longitudinal relationship with suicidal ideation (SI) remains insufficiently characterized. This longitudinal study in MDD patients aimed to (1) examine the associations between somatic symptoms (including total, pain, autonomic, energy, and CNS symptoms) and SI, and (2) investigate potential non-linear relationships among somatic symptoms and their subtypes with SI. Methods Data was collected from patients with MDD in the Depression Cohort in China. The 28-item Somatic Symptoms Inventory (SSI) was used to assess somatic symptoms. SI was measured using the Beck Scale for Suicide Ideation (BSSI). Assessments were conducted at baseline and at weeks 4, 8, 12, 24, 48, and 72. Generalized estimating equations were utilized for exploring the associations of somatic symptoms and their subtypes with SI. GEE across three distinct models: Model 1 (unadjusted); Model 2 adjusted for sociodemographic and lifestyle factors; and Model 3 additionally adjusted for clinical characteristics. All models accounted for baseline SI. Results These studies consisted of 1274 individuals with MDD (mean [SD], 27.7 [6.8] years; 399 (31.3%) males). The adjusted odds ratios (ORs) for SI across quartiles of total somatic symptom scores were 1.0 (reference), 0.95 (95% CI: 0.85-1.07, P = 0.419), 1.20 (95% CI: 1.03-1.41, P = 0.022), and 1.71 (95% CI: 1.39-2.11, P < 0.001) for quartiles 1,2, 3, and 4, respectively. Pain, autonomic, energy, and CNS symptoms showed similar results. A non-linear association (P for nonlinear < 0.001) was observed between total somatic symptom scores and SI. When the total somatic symptom score is below 49, the risk of SI remains at a relatively low level. However, when these scores exceeded the mentioned values, the risk of SI increases rapidly. Conclusions Our findings suggest that in patients with MDD, there is a significant association between somatic symptoms and their subtypes with SI. Notably, the risk of SI is significantly increased by somatic symptoms in a nonlinear manner. These findings highlight the necessity of addressing somatic symptoms in the management of depression and emphasize the importance of developing targeted interventions to mitigate suicide risk in this vulnerable population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".