Deep phenotyping as a contribution to personalized depression therapy: the GEParD and DaCFail protocols

Abstract

Depressive patients suffer from a complex of symptoms of varying intensity compromising their mood, emotions, self-concept, neurocognition, and somatic function. Due to a mosaic of aetiologies involved in developing depression, such as somatic, neurobiological, (epi-)genetic factors, or adverse life events, patients often experience recurrent depressive episodes. About 20–30% of these patients develop difficult-to-treat depression. Here, we describe the design of the GEParD (Genetics and Epigenetics of Pharmaco- and Psychotherapy in acute and recurrent Depression) cohort and the DaCFail (Depression-associated Cardiac Failure) case–control protocol. Both protocols intended to investigate the incremental utility of multimodal biomarkers including cardiovascular and (epi-)genetic markers, functional brain and heart imaging when evaluating the response to antidepressive therapy using comprehensive psychometry. From 2012 to 2020, 346 depressed patients (mean age 45 years) were recruited to the prospective, observational GEParD cohort protocol. Between 2016 and 2020, the DaCFail case–control protocol was initiated integrating four study subgroups to focus on heart-brain interactions and stress systems in patients > 50 years with depression and heart failure, respectively. For DaCFail, 120 depressed patients (mean age 60 years, group 1 + 2), of which 115 also completed GEParD, and 95 non-depressed controls (mean age 66 years) were recruited. The latter comprised 47 patients with heart failure (group 3) and 48 healthy subjects (group 4) of a population-based control group derived from the Characteristics and Course of Heart Failure Stages A–B and Determinants of Progression (STAAB) cohort study. Our hypothesis-driven, exploratory study design may serve as an exemplary roadmap for a standardized, reproducible investigation of personalized antidepressant therapy in an inpatient setting with focus on heart comorbidities in future multicentre studies.

The association between maximal muscle strength, disease severity and psychopharmacotherapy among young to middle-aged inpatients with affective disorders – a prospective pilot study

“…via surveys on smartphones and physiological sensors, EMAs may help to assess possible interaction between both parameters more sensitively than the current study design. Integrating these EMAs into a deep phenotyping approach of depressed inpatients (e.g [ 72 ]), including therapeutic drug monitoring [ 73 ]), may help to personalize (drug) treatment, to monitor motor alterations and to foster PA in young severely ill MDD, BP and SZD patients.…”

Effects of Anxious Depression on Antidepressant Treatment Response

“…The GEParD (Genetics and Epigenetics of Pharmaco-and Psychotherapy in acute and recurrent Depression) sample consisted of 346 depressive patients recruited at the Department of Psychiatry, Psychosomatics and Psychotherapy of the University Hospital of Wuerzburg, Germany [34]. All participants were Caucasian, between 18 and 80 years of age, and diagnosed for unipolar or bipolar depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV [35] criteria.…”

“…A drug-specific summary is given in Supplementary Table S1. More detailed information has been reported elsewhere [34].…”