Symptom Networks of Common Mental Disorders in an Adult Primary Care Sample in India

The common mental disorders (CMDs) which include non-psychotic depression and anxiety-related disorders aggregate mental illnesses commonly seen together without assuming clear diagnostic boundaries. Thus, it provides an excellent platform for a symptom-level investigation of common suffering in regions where the current Western-based diagnostic categories may not apply. This current study investigates the symptom networks of CMDs among adult primary care patients in India, using data from a clinical trial testing the effectiveness of a collaborative stepped-care intervention led by lay health counselors. Network modeling was used to investigate a) symptom centralities, b) boundaries between depression and anxiety-related disorders, and c) baseline differences in network configurations across gender, public versus private health care settings, and treatment response over one-year of follow-up. Intense anxiety/panic and fatigue were the most central symptoms overall. While panic and depressed mood were the most central in public health care settings, fatigue and depressed mood were most central in private settings. Overall, findings indicate central symptoms might differ across cultures and socioeconomic groups. To the knowledge of this current author, this is the first study investigating the symptom networks of CMDs among primary care patients in India.