Prospective biomarkers of major depressive disorder: a systematic review and meta-analysis

Abstract

Leading biological hypotheses propose that biological changes may underlie major depressive disorder onset and relapse/recurrence. Here, we investigate if there is prospective evidence for biomarkers derived from leading theories. We focus on neuroimaging, gastrointestinal factors, immunology, neurotrophic factors, neurotransmitters, hormones, and oxidative stress. Searches were performed in Pubmed, Embase and PsychInfo for articles published up to 06/2019. References and citations of included articles were screened to identify additional articles. Inclusion criteria were having an MDD diagnosis as outcome, a biomarker as predictor, and prospective design search terms were formulated accordingly. PRISMA guidelines were applied. Meta-analyses were performed using a random effect model when three or more comparable studies were identified, using a random effect model. Our search resulted in 67,464 articles, of which 75 prospective articles were identified on: Neuroimaging (N = 24), Gastrointestinal factors (N = 1), Immunology (N = 8), Neurotrophic (N = 2), Neurotransmitters (N = 1), Hormones (N = 39), Oxidative stress (N = 1). Meta-analyses on brain volumes and immunology markers were not significant. Only cortisol (N = 19, OR = 1.294, p = 0.024) showed a predictive effect on onset/relapse/recurrence of MDD, but not on time until MDD onset/relapse/recurrence. However, this effect disappeared when studies including participants with a baseline clinical diagnosis were removed from the analyses. Other studies were too heterogeneous to compare. Thus, there is a lack of evidence for leading biological theories for onset and maintenance of depression. Only cortisol was identified as potential predictor for MDD, but results are influenced by the disease state. High-quality (prospective) studies on MDD are needed to disentangle the etiology and maintenance of MDD.

Depression alters the circadian pattern of online activity

“…Depression is significantly under-reported, under-diagnosed, and under-treated, in part due to its heterogeneous nature which involves subjective and culturally shaped experiences such as motivation, mood, and well-being 3 . Furthermore, in spite of its prevalence, the dynamics of its onset and development remain poorly understood 4 – 6 , limiting the development of treatment options 7 , 8 .…”

Deep Brain Stimulation for Treatment-Resistant Depression: Towards a More Personalized Treatment Approach

“…To overcome this shortcoming, either examining a biological panel of several markers [ 88 ] or phenotyping MDD and TRD into distinct subtypes could be considered. However, a recent meta-analysis showed that only cortisol has a predictive effect on onset/relapse and recurrence of MDD making the integration of biomarkers for personalizing TRD treatment a futuristic milestone yet to be discovered [ 89 ].…”

Duševné zdravie ako komplexný dynamický systém: sieťový prístup k psychopatológii

“…Táto sieť spravidla zahŕňa manifestované prejavy psychickej poruchy (symptómy), no taktiež môže a mala by zahŕňať aj ďalšie externé faktory, ak tieto sú príčinou vzťahov medzi pozorovanými symptómami (Pearl, 2000) alebo prispievajú k celkovej reziliencii, prípadne vulnerabilite. Psychická porucha ako napríklad depresia tak nie je výhradne biologickou poruchou (Kennis et al, 2019), ktorá by mala byť entitou lokalizovanou výlučne v mozgu človeka (de Kovel et al, 2019) alebo alebo poruchou so silným genetickým základom (Border et al, 2019). Etiológia depresie totiž zahŕňa komplexnú interakciu človeka s jeho prostredím (Clark & Chalmers, 1998) Vnímanie povahy psychopatológie na strane klinického psychológa, psychiatra, či psychoterapeuta so sebou zároveň nesie špecifickú interpretáciu povahy a príčin utrpenia na strane pacienta.…”