Back

Atypical energy-related symptoms define biologically distinct subtypes of major depressive disorder

Harder, A.; Wang, R.; Bergstedt, J.; Huider, F.; Kurvits, S.; Thorp, J.; Gong, T.; Assary, E.; Thijssen, A. B.; Merola, G. P.; Goula, A. A.; Bentwood, S.; Karlsson, R.; Pasman, J. A.; Fabbri, C.; Hickie, I. B.; Peyrot, W. J.; Levinson, D. F.; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium, ; Potash, J. B.; Shi, J.; Medland, S. E.; Mitchell, B. L.; Kwong, A. S. F.; Eley, T. C.; Lewis, C. M.; Hamilton, S. P.; Martin, N. G.; Boomsma, D. I.; Lehto, K.; Wray, N. R.; Breen, G.; Penninx, B. W. J. H.; Milaneschi, Y.; Marshall, S.; Thomson, P. A.; Lu, Y.

2026-07-04 genetic and genomic medicine
10.64898/2026.07.02.26357101 medRxiv
Show abstract

Major depressive disorder (MDD) is a complex psychiatric disorder, characterized by a range of mood, cognitive, and neurovegetative symptoms. Current diagnostic criteria treat opposite symptom directions as equivalent; weight gain or loss, and increased or decreased sleep, each count toward a single diagnosis. We defined three subgroups of individuals meeting criteria for MDD: AERS+ (hypersomnia with increased appetite/weight gain), AERS- (insomnia with appetite/weight loss), and an Uncategorized group, and conducted genome-wide association meta-analyses for each (N_eff = 47,858, 156,624, and 215,828, respectively). We identified 27 genome-wide significant loci across subtypes, 4 for AERS+, 10 for AERS- and 13 for Uncategorized. AERS+ showed higher SNP-based heritability (10.9%) and lower polygenicity (1.7% of SNPs) than AERS- (7.9%; 2.9%) or Uncategorized (8.6%; 5.3%), with larger effect sizes at its associated loci. The AERS+ and AERS- subtypes were moderately genetically correlated (r_g= 0.64, se = 0.04). Metabolic traits emerged as a primary differentiator: AERS+ correlated positively with BMI, metabolic syndrome, and related traits, whereas AERS- correlated weakly in the opposite direction. These findings show that the directionality of neurovegetative symptoms indexes genetic heterogeneity within MDD, with metabolic biology as a central axis of differentiation.

Matching journals

The top 2 journals account for 50% of the predicted probability mass.

50% of probability mass above

"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.