scholarly journals Major Depressive Disorder: a possible typisation according to serotonin, inflammation, and metabolic syndrome

2021 ◽  
pp. 1-24
Author(s):  
Ante Silić ◽  
Jakša Vukojević ◽  
Vjekoslav Peitl ◽  
Marc De Hert ◽  
Dalibor Karlović

Abstract Objective: Major depressive disorder (MDD) is closely related to obesity, inflammation, and insulin resistance, all together being etiologically linked to metabolic syndrome development. The depressive disorder has a neuroendocrinological component, co-influencing the metabolic syndrome, while metabolic syndrome (MetS) is characterized by increased cytokine levels, which are known to cause a depressed mood. This study aimed to establish biological subtypes of the depressive disorder based on researched clinical, laboratory, and anthropometric variables. Methods: We performed a cross-sectional study on a sample of 293 subjects (145 suffering from a depressive disorder and 148 healthy controls). Results were analyzed with multivariate statistical methods as well as with cluster and discriminant analysis. In order to classify depressive disorder on the grounds of laboratory, anthropometric, and clinical parameters, we performed cluster analysis, which resulted in three clusters. Results: The first cluster is characterized by low platelet serotonin, high cortisol levels, high blood glucose levels, high triglycerides levels, high HAMD score, increased waist circumference, high CRP values, and a high number of previous depressive episodes, was named Combined (Metabolic) depression. The inflammatory depression cluster is defined with average platelet serotonin values, normal cortisol, and all other parameter levels, except for increased IL-6 levels. The serotoninergic depression cluster is characterized by markedly low platelet serotonin, and all other parameters are within the normal range. Conclusions: From a biological point of view, depressive disorder is not uniform, and as such, these findings suggest potential clinically useful and generalizable biological subtypes of depressive disorder.

2017 ◽  
Vol 92 ◽  
pp. 119-123 ◽  
Author(s):  
Fernanda Pedrotti Moreira ◽  
Karen Jansen ◽  
Taiane de Azevedo Cardoso ◽  
Thaíse Campos Mondin ◽  
Pedro Vieira da Silva Magalhães ◽  
...  

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mostafa S ElShaarawi ◽  
Ayman A Gaafar ◽  
Hisham S. Saad Eldin ◽  
Randa H Ali

Abstract Background Major depressive disorder (MDD) is a common psychiatric disorder that affects nearly 11.1-14.6 % of the population in their lifetime. Pathophysiology and brain imaging findings show that degenerative and inflammatory processes may play a role. Meta-analysis of voxel-based morphometry studies in MDD demonstrated significant gray matter loss. From anatomical and embryological perspectives, the retina can be considered a unique extension of the brain and is able to reflect axonal histopathology. Being unmyelinated, it can provide insight into the pathophysiological processes of diseases with a neurodegenerative element. Aim to compare retinal optical coherence tomography (OCT) parameters in a group of MDD patients with a healthy control group and to correlate OCT parameters with pattern electroretinography (PERG) parameters. Method a controlled cross sectional study was conducted on 30 MDD patients and 28 age and sex matched controls. Both groups had a full ophthalmological examination, OCT imaging and 7 patients and 11 controls have PERG recorded. Results Thinning of the superior retinal nerve fiber layer, thinning of most of the ganglion cell inner plexiform (GCIP) layer, thinning of most of the macular thickness and thinning of macular volume in both eyes were detected. There was a statistically significant positive correlation between the left GCIP layer and the amplitude of the N95 wave. Also a statistically significant negative correlation existed between MDD duration in years with the left eye's average volume of the outer ring of the macula. Conclusion Significant retinal changes were detected by OCT in MDD patients supporting the theory of neurodegeneration as a pathophysiology of MDD.


2021 ◽  
Vol 30 ◽  
Author(s):  
Annelieke M. Roest ◽  
Ymkje Anna de Vries ◽  
Ali Al-Hamzawi ◽  
Jordi Alonso ◽  
Olatunde O. Ayinde ◽  
...  

Abstract Aims Major depressive disorder (MDD) is characterised by a recurrent course and high comorbidity rates. A lifespan perspective may therefore provide important information regarding health outcomes. The aim of the present study is to examine mental disorders that preceded 12-month MDD diagnosis and the impact of these disorders on depression outcomes. Methods Data came from 29 cross-sectional community epidemiological surveys of adults in 27 countries (n = 80 190). The Composite International Diagnostic Interview (CIDI) was used to assess 12-month MDD and lifetime DSM-IV disorders with onset prior to the respondent's age at interview. Disorders were grouped into depressive distress disorders, non-depressive distress disorders, fear disorders and externalising disorders. Depression outcomes included 12-month suicidality, days out of role and impairment in role functioning. Results Among respondents with 12-month MDD, 94.9% (s.e. = 0.4) had at least one prior disorder (including previous MDD), and 64.6% (s.e. = 0.9) had at least one prior, non-MDD disorder. Previous non-depressive distress, fear and externalising disorders, but not depressive distress disorders, predicted higher impairment (OR = 1.4–1.6) and suicidality (OR = 1.5–2.5), after adjustment for sociodemographic variables. Further adjustment for MDD characteristics weakened, but did not eliminate, these associations. Associations were largely driven by current comorbidities, but both remitted and current externalising disorders predicted suicidality among respondents with 12-month MDD. Conclusions These results illustrate the importance of careful psychiatric history taking regarding current anxiety disorders and lifetime externalising disorders in individuals with MDD.


2014 ◽  
Vol 205 (4) ◽  
pp. 268-274 ◽  
Author(s):  
Pim Cuijpers ◽  
Sander L. Koole ◽  
Annemiek van Dijke ◽  
Miquel Roca ◽  
Juan Li ◽  
...  

BackgroundThere is controversy about whether psychotherapies are effective in the treatment of subclinical depression, defined by clinically relevant depressive symptoms in the absence of a major depressive disorder.AimsTo examine whether psychotherapies are effective in reducing depressive symptoms, reduce the risk of developing major depressive disorder and have comparable effects to psychological treatment of major depression.MethodWe conducted a meta-analysis of 18 studies comparing a psychological treatment of subclinical depression with a control group.ResultsThe target groups, therapies and characteristics of the included studies differed considerably from each other, and the quality of many studies was not optimal. Psychotherapies did have a small to moderate effect on depressive symptoms against care as usual at the post-test assessment (g = 0.35, 95% CI 0.23–0.47; NNT = 5, 95% CI 4–8) and significantly reduced the incidence of major depressive episodes at 6 months (RR = 0.61) and possibly at 12 months (RR = 0.74). The effects were significantly smaller than those of psychotherapy for major depressive disorder and could be accounted for by non-specific effects of treatment.ConclusionsPsychotherapy may be effective in the treatment of subclinical depression and reduce the incidence of major depression, but more high-quality research is needed.


2011 ◽  
Vol 26 (S2) ◽  
pp. 333-333
Author(s):  
M.L. Perereira ◽  
D.L. Nunes Peçanha ◽  
I.A. Santos Bordin

IntroductionPsychiatric disorders occur in a complex context of human relations in its social and psychological aspects. Family functioning is closely related to physical and psychological well-being of family members and its impairment affects the family as a whole.ObjectivesTo evaluate family functioning in two groups of adolescents (13–18 years): cases (with major depressive disorder) and controls (with no DSM-IV psychiatric disorders based on the Brazilian version of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime/K-SADS-PL).MethodFamilies of cases (N = 9) and controls (N = 9) were matched by adolescent's age, gender and education, number and age of siblings, parental marital status and occupational activity, and family income. An experienced systemic family therapist applied the Structured Family Interview to each family. Nine dimensions of family functioning were evaluated: communication, rules, roles, leadership, conflict, aggressiveness, affect, individuation and integration. Session transcripts were independently evaluated by two other systemic family therapists blind to the family case-control category.ResultsRaters scored all interview items using a standardized coding system (overall agreement = 83.5%). Cases exhibited lower mean scores in seven family dimensions, specially affect (p = 0.0078). Differences were not found regarding rules and leadership.ConclusionDifficulty in expressing affect in parent-child relationships was the main characteristic of families with a depressive adolescent. Improvement of family functioning can contribute to minimize the negative influence of psychosocial and family factors on the reoccurrence, and severity of depressive episodes among depressed adolescents.


Cephalalgia ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 347-356 ◽  
Author(s):  
Claudia Pisanu ◽  
Emma Lundin ◽  
Martin Preisig ◽  
Mehdi Gholam-Rezaee ◽  
Enrique Castelao ◽  
...  

Objective Migraine and major depressive disorder show a high rate of comorbidity, but little is known about the associations between the subtypes of major depressive disorder and migraine. In this cross-sectional study we aimed at investigating a) the lifetime associations between the atypical, melancholic, combined and unspecified subtype of major depressive disorder and migraine with and without aura and b) the associations between major depressive disorder and its subtypes and the severity of migraine. Methods A total of 446 subjects with migraine (migraine without aura: n = 294; migraine with aura: n = 152) and 2511 controls from the population-based CoLaus/PsyCoLaus study, Switzerland, were included. Associations between major depressive disorder subtypes and migraine characteristics were tested using binary logistic or linear regression. Results Melancholic, combined and unspecified major depressive disorder were associated with increased frequency of migraine with aura, whereas only melancholic major depressive disorder was associated with increased frequency of migraine without aura. Lifetime and unspecified major depressive disorder were associated with severe migraine intensity among subjects with migraine with aura but not migraine without aura, while combined major depressive disorder was associated with higher migraine frequency independently from migraine subtype. Conclusion This study suggests that melancholic but not atypical major depressive disorder is associated with migraine and migraine subtypes. Future studies exploring pathophysiological mechanisms shared between melancholic depression and migraine are warranted.


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