Anticipating depression trajectories by measuring plasticity and change through symptom network dynamics

• Published in: European psychiatry Vol. 68; no. 1; p. e128
• Main Authors: Delli Colli, Claudia, Viglione, Aurelia, Giuliani, Alessandro, Branchi, Igor
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 15.08.2025
• Subjects: Adult; Clinical trials; Connectivity; Depression - physiopathology; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - physiopathology; Disease Progression; Female; Humans; Male; Mental depression; Mental disorders; Mental health; Middle Aged; network analysis; Neuronal Plasticity - physiology; precision psychiatry; prediction; Questionnaires; recovery; remission; Severity of Illness Index; treatment response; precision psychiatry; connectivity; mental health; treatment response; remission; prediction; network analysis; recovery
• ISSN: 0924-9338; 1778-3585; 1778-3585
• DOI: 10.1192/j.eurpsy.2025.10083

Network analysis is a promising approach for elucidating the dynamics of the transition from psychopathology to well-being. Recently, symptom connectivity strength has been proposed as a measure of plasticity - the capacity to change disease severity. Yet, empirical findings remain inconsistent. We propose that this inconsistency can be resolved by recognizing that the interpretation of connectivity strength varies along the recovery process from depression, whether at baseline or during clinical change. We analyzed 2,710 depressed patients from the STAR*D dataset, grouped by the magnitude of change in depressive score. Symptom network connectivity was estimated from QIDS-C items at three time points: (i) baseline, (ii) change - defined as when clinical change in depression score occurs, (iii) post-change - corresponding to when the maximum clinical change is achieved. At baseline, connectivity strength predicts the maximum clinical change, inversely correlating with its magnitude (  = -0.95,  = 0.001). At the change time point, connectivity strength parallels clinical change (  = 0.92,  = 0.002). A direct and significant association between connectivity strength and depression severity emerges only at the change (ρ = 0.98, p = 0.0003) and post-change (ρ = 0.95, p = 0.001) time points. The interpretation of connectivity strength for predicting depression trajectories varies by timepoint: at baseline, it measures plasticity -- the capacity for change -- whereas during clinical change, it indicates the magnitude of change in symptom severity. This framework supports the reliability of this prognostic marker for designing personalized therapeutic interventions in psychiatry.