The dynamics of psychological attributes and symptomatic comorbidity of depression in children and adolescents.

PURPOSE: This investigation aimed to explore attribute dynamics and symptomatic comorbidity of depression with internalizing, externalizing, and other personal-contextual problems in children and adolescents from a network analysis. METHODS: We tested an attribute network of regularized partial correlations, standard and alternative centrality measures, and comorbidity bridge symptoms according to centrality bridge measures. RESULTS: Regularized partial correlation network and a centrality measures graph shown the prominent position of social problems and anxiety-depression. Minimum spanning tree (MST) found a hierarchical dynamics between attributes where mixed anxiety-depression was identified as the core and the other attributes were hierarchically connected to it by being positioned in six branches that are differentiated according to their theoretical contents. The most central connections are established with the attributes of their own community or theoretical groups, and 37 bridge symptoms were identified in all networks. CONCLUSIONS: A significant role of mixed anxiety depression as an activator and intermediary of psychopathologies was supported as a central attribute of internalizing problems. Aggressive behavior as part of the broad externalizing dimension was one of the constructs that most intensively activate the network, and social problems were also distinguished as a relevant factor not only in terms of connections and central attributes but also in terms of bridge symptoms and comorbidity. This framework extends to the study of symptomatic "comorbidity."

Anxiety and Depression Symptoms in Spanish Children and Adolescents: An Exploration of Comorbidity from the Network Perspective.

The combination of depression and anxiety is among the most prevalent comorbidities of disorders leading to substantial functional impairment in children and adolescents. The network perspective offers a new paradigm for understanding and measuring psychological constructs and their comorbidity. The present study aims to apply network analysis to explore the comorbidity between depression and anxiety symptoms. Specifically, the study examines bridge symptoms, comorbidity, and shortest pathway networks and estimates the impact of the symptoms in the network's connectivity and structure. The findings show that "feeling lonely" and "feeling unloved" are identified as the most central bridge symptoms. The shortest path network suggests that the role of a mixed anxiety-depressive symptomatology, and specific and non-specific symptoms of clinical criteria, such as "worries," "feels depressed," "fears school," and "talks about suicide" could serve as a warning for comorbidity.

Knee chondral lesions: incidence and correlation between arthroscopic and magnetic resonance findings.

PURPOSE: To determine the incidence and morphologic characteristics of knee chondral lesions found at arthroscopy and their correlation with magnetic resonance imaging (MRI). METHODS: This is a prospective study on 190 consecutive knee arthroscopic procedures performed between March 2003 and February 2004 by the same surgical team. The study group's age average was 34.8 years (14 to 77 years). The indication for surgery included anterior cruciate ligament tears, meniscal tears, and anterior knee pain. Patients without a preoperative MRI study were excluded. MRI reports were performed by qualified radiologists in all the cases. Chondral lesions were classified according to the International Cartilage Repair Society (ICRS) classification and were included in a database along with the MRI reports. The results were analyzed statistically with analysis of variance, Pearson, kappa, and chi-square tests. RESULTS: One hundred fifteen chondral lesions in 82 patients were found during the arthroscopic procedure. Most of them were single lesions (72%) located on the medial femoral condyle (32.2%) or medial patellae (22.6%); 62.6% of the lesions were classified as ICRS type 2 or 3-A, with an average surface of 1.99 cm2. We found a significant direct correlation between the patient's age and the size of the lesion (P = .001). MRI sensitivity was 45% with a specificity of 100%. The sensitivity increased with deeper lesions (direct relation with the ICRS classification). Our results showed a statistical power of 100%. CONCLUSIONS: Although unenhanced MRI using a 1.5-Tesla magnet with conventional sequences (proton density-weighted, T1-weighted, and T2-weighted) is most accurate at revealing deeper lesions and defects at the patellae, our study shows that a considerable number of lesions will remain undetected until arthroscopy, which remains the gold standard. LEVEL OF EVIDENCE: Level III, diagnostic study of nonconsecutive patients.