Asymmetry in the Association Between Depression Subtypes and Health-Related Outcomes

McKeough, Jen E.; Sharpley, Christopher F.; Bitsika, Vicki; Vessey, Kirstan A.; Williams, Rebecca J.; Odierna, G. Lorenzo; Evans, Ian D.

doi:10.3390/sym18010020

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Open AccessArticle

Asymmetry in the Association Between Depression Subtypes and Health-Related Outcomes

by

Jen E. McKeough

,

Christopher F. Sharpley

,

Vicki Bitsika

^*

,

Kirstan A. Vessey

,

Rebecca J. Williams

,

G. Lorenzo Odierna

and

Ian D. Evans

Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia

^*

Author to whom correspondence should be addressed.

Symmetry 2026, 18(1), 20; https://doi.org/10.3390/sym18010020

Submission received: 26 October 2025 / Revised: 15 December 2025 / Accepted: 19 December 2025 / Published: 22 December 2025

(This article belongs to the Section Life Sciences)

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Abstract

This study aimed to assess the association between four depression subtypes and health-related symptoms. Although it was expected that there would be asymmetry across the associations between depression subtypes and health, that relationship had not been previously reported. Data on the core diagnostic symptoms of depression and four depression subtypes, plus health-related outcomes, were collected from a sample of 301 community participants who completed standardised self-report questionnaires. Results indicated that Somatic Depression and Depressed Mood were most consistently associated with poorer outcomes across physical, emotional, and social domains, while Cognitive Depression and Anhedonia subtypes showed weaker associations. An exploratory network analysis identified Social Functioning and Depressed Mood as central nodes, indicating that affective disturbance and social wellbeing are key pathways through which depression relates to wider health outcomes. In conclusion, these results confirmed the heterogeneity of depression, as well as indicating that certain symptom clusters carry disproportionate weight in predicting health outcomes, thus exhibiting an asymmetrical pattern of associations between depression and health.

Keywords: depression; health; network; diagnosis; treatment

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MDPI and ACS Style

McKeough, J.E.; Sharpley, C.F.; Bitsika, V.; Vessey, K.A.; Williams, R.J.; Odierna, G.L.; Evans, I.D. Asymmetry in the Association Between Depression Subtypes and Health-Related Outcomes. Symmetry 2026, 18, 20. https://doi.org/10.3390/sym18010020

AMA Style

McKeough JE, Sharpley CF, Bitsika V, Vessey KA, Williams RJ, Odierna GL, Evans ID. Asymmetry in the Association Between Depression Subtypes and Health-Related Outcomes. Symmetry. 2026; 18(1):20. https://doi.org/10.3390/sym18010020

Chicago/Turabian Style

McKeough, Jen E., Christopher F. Sharpley, Vicki Bitsika, Kirstan A. Vessey, Rebecca J. Williams, G. Lorenzo Odierna, and Ian D. Evans. 2026. "Asymmetry in the Association Between Depression Subtypes and Health-Related Outcomes" Symmetry 18, no. 1: 20. https://doi.org/10.3390/sym18010020

APA Style

McKeough, J. E., Sharpley, C. F., Bitsika, V., Vessey, K. A., Williams, R. J., Odierna, G. L., & Evans, I. D. (2026). Asymmetry in the Association Between Depression Subtypes and Health-Related Outcomes. Symmetry, 18(1), 20. https://doi.org/10.3390/sym18010020

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Asymmetry in the Association Between Depression Subtypes and Health-Related Outcomes

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