Differentiating melancholic and non-melancholic depression via biological markers: A review

Spoelma, Michael J.; Serafimovska, Anastasia; Parker, Gordon

doi:10.1080/15622975.2023.2219725

Cited by 6 publications

(3 citation statements)

References 133 publications

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“…A recent meta-analysis of 82 studies performed in 6010 participants (3212 participants with MDD and 2798 HCs) reported consistent increased levels of the pro-inflammatory cytokines IL-6 ( g = 0.621; P < 0.001) and TNF-α ( g = 0.638; P < 0.001) in MDD compared to HC [ 59 ]. Interestingly, different biomarker profiles could be associated with subtypes of MDD, with elevated levels of TNF in atypical depression (characterized, according to DSM-5, by a higher reactivity to environmental stressors) [ 60 ], and mixed findings in melancholic depression [ 59 ], less reactive to the environment, and with a higher HPA axis activation which might influence peripheral levels of inflammatory markers [ 61 – 63 ]. Interestingly, elevated levels of plasma TNF-α were found in patients with atypical depression [ 60 ], but not in patients with melancholic depression [ 59 ].…”

Section: Methodsmentioning

confidence: 99%

“…Interestingly, different biomarker profiles could be associated with subtypes of MDD, with elevated levels of TNF in atypical depression (characterized, according to DSM-5, by a higher reactivity to environmental stressors) [ 60 ], and mixed findings in melancholic depression [ 59 ], less reactive to the environment, and with a higher HPA axis activation which might influence peripheral levels of inflammatory markers [ 61 – 63 ]. Interestingly, elevated levels of plasma TNF-α were found in patients with atypical depression [ 60 ], but not in patients with melancholic depression [ 59 ]. This finding is in line with the hypothesis that melancholic depression is associated with increased activity of the HPA axis which would lower inflammation [ 61 , 62 ].…”

Section: Methodsmentioning

confidence: 99%

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Inflammatory mediators in major depression and bipolar disorder

Poletti,

Mazza,

Benedetti

2024

Transl Psychiatry

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Major depressive disorder (MDD) and bipolar disorder (BD) are highly disabling illnesses defined by different psychopathological, neuroimaging, and cognitive profiles. In the last decades, immune dysregulation has received increasing attention as a central factor in the pathophysiology of these disorders. Several aspects of immune dysregulations have been investigated, including, low-grade inflammation cytokines, chemokines, cell populations, gene expression, and markers of both peripheral and central immune activation. Understanding the distinct immune profiles characterizing the two disorders is indeed of crucial importance for differential diagnosis and the implementation of personalized treatment strategies. In this paper, we reviewed the current literature on the dysregulation of the immune response system focusing our attention on studies using inflammatory markers to discriminate between MDD and BD. High heterogeneity characterized the available literature, reflecting the heterogeneity of the disorders. Common alterations in the immune response system include high pro-inflammatory cytokines such as IL-6 and TNF-α. On the contrary, a greater involvement of chemokines and markers associated with innate immunity has been reported in BD together with dynamic changes in T cells with differentiation defects during childhood which normalize in adulthood, whereas classic mediators of immune responses such as IL-4 and IL-10 are present in MDD together with signs of immune-senescence.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Inflammatory mediators in major depression and bipolar disorder

Poletti,

Mazza,

Benedetti

2024

Transl Psychiatry

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“…A review ( Parker, 2021 ) identified several studies supporting a strong genetic contribution. Another review ( Spoelma et al, 2023 ) identified a very large number of biological markers over-represented in those with melancholic depression. Assuming for the moment that it is an entity, then lack of any acceptance of such status is likely a reflection of difficulties in defining and measuring ‘melancholia’.…”

Section: Utility Of the ‘Binary’ Model?mentioning

confidence: 99%

A revisionist model for treatment-resistant and difficult-to-treat depression

Parker

2024

Aust N Z J Psychiatry

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Objective: The aim of this study is to consider limitations to the heuristics ‘treatment-resistant depression’ (TRD) and ‘difficult-to-treat’ depression (DTD) and to offer a revisionist model. Methods: A number of limitations to the two constructs are noted, particularly the risk of each positioning clinical depression as an entity and then applying a linear sequencing management model. Results: Arguing that clinical depression is heterogenous in nature (with categorical and ‘fuzzy set conditions), in cause and in response to treatment, allows an alternate model for addressing depressive conditions that are not readily responsive to treatment. A skeletal model for proceeding is offered for consideration and development. Conclusion: If such a model is accepted, then differing criteria for defining treatment resistance and treatment failure might be generated for differing depressive conditions, and condition-specific sequencing algorithms (embracing drug and non-drug strategies) developed for their management.

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