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Peer-reviewedCC BY-NC-ND 4.0Journal of Child Psychology and Psychiatry, and Allied Disciplines

A latent class analysis of depressive symptoms in youth from the Texas Youth Depression and Suicide Research Network (TX‐YDSRN): Clinical and socio‐ecological correlates

  • Rachel Lee1
  • Erika S. Trent1
  • Kevin M. Wagner1
  • Ace A. Castillo1,2
  • Abu Minhajuddin2,3
  • Joseph Blader4
  • Cesar A. Soutullo5
  • Denise Baughn6
  • Hadeel Hamdan6
  • Kirti Saxena1
  • Rachel A. Walker2
  • Lynnel C. Goodman2
4 more authors
  • Sarah M. Wakefield7
  • Wayne K. Goodman1
  • Madhukar H. Trivedi2
  • Eric A. Storch1
7 affiliations
  1. 1Menninger Department of Psychiatry and Behavioral Sciences Baylor College of Medicine Houston TX USA
  2. 2Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry University of Texas Southwestern Medical Center Dallas TX USA
  3. 3Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center Dallas TX USA
  4. 4Department of Psychiatry and Behavioral Sciences Joe R. and Teresa Lozano Long School of Medicine, University of Texas at San Antonio San Antonio TX USA
  5. 5The University of Texas Health (UTHealth) Houston, Louis A. Faillace Department of Psychiatry and Behavioral Sciences Houston TX USA
  6. 6Department of Psychiatry and Behavioral Sciences University of Texas Medical Branch Galveston TX USA
  7. 7Department of Psychiatry Texas Tech University Health Science Center Lubbock TX USA
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Abstract

Background: Adolescent depression is heterogeneous, yet many studies rely on aggregate symptom scores that may obscure meaningful differences in symptom presentation. Latent class analysis (LCA) offers a person‐centered approach for identifying symptom subgroups, but few studies have examined depressive symptom classes longitudinally with attention to social determinants of health (SDoH). This study identified depressive symptom classes among youth with depression and/or suicidality, examined demographic, clinical, and socio‐ecological correlates of class membership, and evaluated changes in psychological outcomes over 6 months.

Methods: Participants were 1,825 youth ages 8–20 years who screened positive for depression, endorsed suicidal thoughts or behaviors, or were receiving treatment for depression. Baseline Patient Health Questionnaire for Adolescents (PHQ‐A) item responses were used to identify latent classes of depressive symptoms. Associations between class membership and sociodemographic characteristics, trauma exposure, health‐related social needs, treatment barriers, anxiety, suicidality and resilience were examined using chi‐square tests and analyses of variance. Mixed‐effect models evaluated changes in clinical symptoms and resilience across 6 months of follow‐up.

Results: A five‐class solution was identified: Somatic Symptoms (15.6%), No Symptoms (12.4%), Mild Symptoms (20.5%), Moderate Symptoms (27.8%), and High Symptoms (23.5%). Classes differed significantly by sex, trauma exposure, interpersonal safety concerns, treatment barriers, anxiety severity, suicidality, and resilience. In contrast, household income and basic resource insecurities did not differ significantly across classes. Longitudinally, depressive symptoms, anxiety, and suicidality showed significant time‐by‐class interactions; however, within‐ and between‐class effect sizes were generally small. Resilience did not exhibit differential changes across classes.

Conclusions: Depressive symptom classes among youth with depression or suicidality demonstrate distinct clinical and socio‐ecological profiles, highlighting meaningful heterogeneity beyond symptom severity alone. Person‐centered approaches may improve characterization of adolescent depression and inform more tailored assessment and intervention strategies. Future longitudinal research should examine the stability of these classes and predictors of transitions between symptom classes.

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Cite

BibTeXRIS
BibTeX
@article{lee2026latent,
  title = {{A latent class analysis of depressive symptoms in youth from the Texas Youth Depression and Suicide Research Network (TX‐YDSRN): Clinical and socio‐ecological correlates}},
  author = {Rachel Lee and Erika S. Trent and Kevin M. Wagner and Ace A. Castillo and Abu Minhajuddin and Joseph Blader and Cesar A. Soutullo and Denise Baughn and Hadeel Hamdan and Kirti Saxena and Rachel A. Walker and Lynnel C. Goodman and Sarah M. Wakefield and Wayne K. Goodman and Madhukar H. Trivedi and Eric A. Storch},
  journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines},
  year = {2026},
  month = aug,
  doi = {10.1111/jcpp.70211},
  url = {https://doi.org/10.1111/jcpp.70211},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - A latent class analysis of depressive symptoms in youth from the Texas Youth Depression and Suicide Research Network (TX‐YDSRN): Clinical and socio‐ecological correlates
AU  - Rachel Lee
AU  - Erika S. Trent
AU  - Kevin M. Wagner
AU  - Ace A. Castillo
AU  - Abu Minhajuddin
AU  - Joseph Blader
AU  - Cesar A. Soutullo
AU  - Denise Baughn
AU  - Hadeel Hamdan
AU  - Kirti Saxena
AU  - Rachel A. Walker
AU  - Lynnel C. Goodman
AU  - Sarah M. Wakefield
AU  - Wayne K. Goodman
AU  - Madhukar H. Trivedi
AU  - Eric A. Storch
PY  - 2026
DA  - 2026/08/01
JO  - Journal of Child Psychology and Psychiatry, and Allied Disciplines
DO  - 10.1111/jcpp.70211
UR  - https://doi.org/10.1111/jcpp.70211
AB  - Background: Adolescent depression is heterogeneous, yet many studies rely on aggregate symptom scores that may obscure meaningful differences in symptom presentation. Latent class analysis (LCA) offers a person‐centered approach for identifying symptom subgroups, but few studies have examined depressive symptom classes longitudinally with attention to social determinants of health (SDoH). This study identified depressive symptom classes among youth with depression and/or suicidality, examined demographic, clinical, and socio‐ecological correlates of class membership, and evaluated changes in psychological outcomes over 6 months.  Methods: Participants were 1,825 youth ages 8–20 years who screened positive for depression, endorsed suicidal thoughts or behaviors, or were receiving treatment for depression. Baseline Patient Health Questionnaire for Adolescents (PHQ‐A) item responses were used to identify latent classes of depressive symptoms. Associations between class membership and sociodemographic characteristics, trauma exposure, health‐related social needs, treatment barriers, anxiety, suicidality and resilience were examined using chi‐square tests and analyses of variance. Mixed‐effect models evaluated changes in clinical symptoms and resilience across 6 months of follow‐up.  Results: A five‐class solution was identified: Somatic Symptoms (15.6%), No Symptoms (12.4%), Mild Symptoms (20.5%), Moderate Symptoms (27.8%), and High Symptoms (23.5%). Classes differed significantly by sex, trauma exposure, interpersonal safety concerns, treatment barriers, anxiety severity, suicidality, and resilience. In contrast, household income and basic resource insecurities did not differ significantly across classes. Longitudinally, depressive symptoms, anxiety, and suicidality showed significant time‐by‐class interactions; however, within‐ and between‐class effect sizes were generally small. Resilience did not exhibit differential changes across classes.  Conclusions: Depressive symptom classes among youth with depression or suicidality demonstrate distinct clinical and socio‐ecological profiles, highlighting meaningful heterogeneity beyond symptom severity alone. Person‐centered approaches may improve characterization of adolescent depression and inform more tailored assessment and intervention strategies. Future longitudinal research should examine the stability of these classes and predictors of transitions between symptom classes.
SN  - 0021-9630
SN  - 1469-7610
ER  -