Evidence map›Paper›PMID 30900257›Full record

ArticleJournal of child psychology and psychiatry, and allied disciplines2019

In search of disorders: internalizing symptom networks in a large clinical sample.

Eoin McElroy, Praveetha Patalay

Abstract read
In one paragraph

Article in Journal of child psychology and psychiatry, and allied disciplines, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Eoin McElroyInstitute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.ORCID 0000-0001-5466-8522
Praveetha PatalayInstitute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.ORCID 0000-0002-5341-3461

Funding

Wellcome TrustWellcome Trust 204366/Z/16/Z
6 · The paper itself

Abstract

backgroundThe co-occurrence of internalizing disorders is a common form of psychiatric comorbidity, raising questions about the boundaries between these diagnostic categories. We employ network psychometrics in order to: (a) determine whether internalizing symptoms cluster in a manner reflecting DSM diagnostic criteria, (b) gauge how distinct these diagnostic clusters are and (c) examine whether this network structure changes from childhood to early and then late adolescence.

methodSymptom-level data were obtained for service users in publicly funded mental health services in England between 2011 and 2015 (N = 37,162). A symptom network (i.e. Gaussian graphical model) was estimated, and a community detection algorithm was used to explore the clustering of symptoms.

resultsThe estimated network was densely connected and characterized by a multitude of weak associations between symptoms. Six communities of symptoms were identified; however, they were weakly demarcated. Two of these communities corresponded to social phobia and panic disorder, and four did not clearly correspond with DSM diagnostic categories. The network structure was largely consistent by sex and across three age groups (8-11, 12-14 and 15-18 years). Symptom connectivity in the two older age groups was significantly greater compared to the youngest group and there were differences in centrality across the age groups, highlighting the age-specific relevance of certain symptoms.

conclusionsThese findings clearly demonstrate the interconnected nature of internalizing symptoms, challenging the view that such pathology takes the form of distinct disorders.

Indexed as

AdolescentBehavioral SymptomsChildCluster AnalysisComorbidityDiagnostic and Statistical Manual of Mental DisordersEnglandFemaleHumansMaleMental DisordersPsychometricsanxietycomorbiditydepressiondevelopmental psychopathologynetwork analysisNosology

Identifiers

PMID30900257
PMCPMC6767473

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.