Transdiagnostic biomarker approaches to mental health disorders: Consideration of symptom complexity, comorbidity and context

McQuaid, Robyn J.

doi:10.1016/j.bbih.2021.100303

Cited by 13 publications

(10 citation statements)

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“…Together, the variability in symptom profiles and comorbid features across disorders can impede treatment efficacy [ 5 ]. With approximately only one-third of individuals receiving an antidepressant treatment reaching remission [ 6 ], a better understanding of the neurobiology of complex mental health disorders is needed, which reflects the heterogeneity and comorbidity that exists [ 7 , 8 ]. To address this need, the Research Domain Criteria (RDoC) introduced by the US National Institute of Mental Health, is focused on shifting biomarker research away from the constraints of diagnostic categories in an effort to identify the neurobiology of dimensions that cut across disorders [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…There is evidence that shifting biomarker research away from the constraints of diagnostic categories can effectively differentiate dimensions that cut across disorders according to neurobiology, which has implications for informing personalized or tailored treatments [ 8 , 9 , 17 ]. Thus, the current investigation focused on characterizing meaningful subtypes (i.e., clusters) of individuals according to depressive and anxiety symptomatologies, and explored whether peripheral biomarkers, including cortisol, CRP, IL-6, and TNF-α levels could be used to differentiate symptom clusters.…”

Section: Introductionmentioning

confidence: 99%

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Developing symptom clusters: linking inflammatory biomarkers to depressive symptom profiles

et al. 2022

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Considering the burden of depression and the lack of efficacy of available treatments, there is a need for biomarkers to predict tailored or personalized treatments. However, identifying reliable biomarkers for depression has been challenging, likely owing to the vast symptom heterogeneity and high rates of comorbidity that exists. Examining biomarkers that map onto dimensions of depression as well as shared symptoms/constructs that cut across disorders could be most effective for informing personalized treatment approaches. With a sample of 539 young adults, we conducted a principal component analysis (PCA) followed by hierarchical cluster analysis to develop transdiagnostic clusters of depression and anxiety symptoms. We collected blood to assess whether neuroendocrine (cortisol) and inflammatory profiles (C-reactive protein (CRP), Interleukin (IL)-6, and tumor necrosis factor (TNF) – α) could be used to differentiate symptom clusters. Six distinct clusters were identified that differed significantly on symptom dimensions including somatic anxiety, general anxiety, anhedonia, and neurovegetative depression. Moreover, the neurovegetative depression cluster displayed significantly elevated CRP levels compared to other clusters. In fact, inflammation was not strongly associated with overall depression scores or severity, but rather related to specific features of depression marked by eating, appetite, and tiredness. This study emphasizes the importance of characterizing the biological underpinnings of symptom dimensions and subtypes to better understand the etiology of complex mental health disorders such as depression.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Developing symptom clusters: linking inflammatory biomarkers to depressive symptom profiles

et al. 2022

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“…However, the plausible impact of narcissistic traits on psychological adjustment in relation to other traumatic experiences, and therefore the presence of post-traumatic symptoms, has rarely been [17,18]. Moreover, despite the proven utility of the transdiagnostic approach in the treatment of mental health problems [5,[34][35][36], and the mixed results regarding the relationship between the two types of narcissism (Vulnerable vs. Grandiose) and mental health adjustment, few studies have focused on their individual constituents, especially with respect to grandiose narcissism dimensions, the effects of which on health outcomes and self-regulation seem to be mediated by a positive outlook [32,33].…”

Section: Introductionmentioning

confidence: 99%

Narcissistic Personality and Its Relationship with Post-Traumatic Symptoms and Emotional Factors: Results of a Mediational Analysis Aimed at Personalizing Mental Health Treatment

Montoro

Coba

Moreno-Padilla

et al. 2022

Behavioral Sciences

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Background: Narcissism is characterized by entitlement, grandiose fantasies and the need for admiration. This personality trait has been associated with both traumatic experiences and emotional problems. Most studies have only focused on narcissism in the context of childhood trauma and negative emotional factors. However, dimensions of grandiose narcissism such as authority have been linked to adaptive outcomes. Furthermore, narcissism might not be linked only to negative childhood experiences; it may also be associated with the presence of post-traumatic symptoms. Therefore, the present study aimed to assess the associations between narcissism and the frequency and severity of post-traumatic symptoms and emotional factors (resilience capacity, emotional regulation, positive and negative affect, intolerance of uncertainty and perceived stress), as well as the possible mediational role of the latter in the relationship between narcissism and post-traumatic symptoms. Method: A total of 115 healthy young psychology undergraduates and their relatives, aged from 18 to 40 years, were asked to complete a set of questionnaires to evaluate the aforementioned variables. Results: The results showed that most of the grandiose narcissism dimensions were positively related to emotional adaptive outcomes, except exploitativeness and entitlement. The negative associations observed between the frequency and severity of post-traumatic symptoms and narcissism (self-sufficiency) were mediated by affect and resilience, which were in turn positively associated with the majority of the narcissism dimensions. Both positive affect and resilience were important factors mediating the association between grandiose narcissism and post-traumatic symptoms. Conclusions: Our findings reaffirm the need to assess not only desirable personality traits, but also ones that are not initially desirable, before pathologizing them. This consideration may be essential to achieve a personalized approach to the prevention of mental health problems, and promotion of positive emotions, in the general population.

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“…Depressive symptomatology is a transdiagnostic feature frequently comorbid in psychiatric disorders, with highly heterogeneous symptoms, typically physical and emotional-cognitive symptoms encompassing feelings of worthlessness, guilt, shame, lowered selfesteem, and hopelessness. Heterogeneity and comorbidity of depression symptoms impact the response to first-line treatment [1][2][3][4], contributing to higher suicide risk. Some authors consider mental pain a part of depression, although doubts still exist about a clear distinction between major depression and mental pain [5,6].…”

Section: Introductionmentioning

confidence: 99%

High depression symptomatology and mental pain characterize suicidal psychiatric patients

et al. 2022

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Background Symptoms of depression are transdiagnostic heterogenous features frequently assessed in psychiatric disorders, that impact the response to first-line treatment and are associated with higher suicide risk. This study assessed whether severe mental pain could characterize a specific phenotype of severely depressed high-risk psychiatric patients. We also aimed to analyze differences in treatments administered. Methods 2,297 adult patients (1,404 females and 893 males; mean age = 43.25 years, SD = 15.15) treated in several Italian psychiatric departments. Patients were assessed for psychiatric diagnoses, mental pain, symptoms of depression, hopelessness, and suicide risk. Results More than 23% of the patients reported high depression symptomatology and high mental pain (HI DEP/HI PAIN). Compared to patients with lower symptoms of depression, HI DEP/HI PAIN is more frequent among females admitted to an inpatient department and is associated with higher hopelessness and suicide risk. In addition, HI DEP/HI PAIN (compared to both patients with lower symptoms of depression and patients with higher symptoms of depression but lower mental pain) were more frequently diagnosed in patients with personality disorders and had different treatments. Conclusions Patients reporting severe symptoms of depression and high mental pain presented a mixture of particular dangerousness (high trait hopelessness and the presence of suicide ideation with more frequency and less controllability and previous suicide behaviors). The presence of severe mental pain may act synergically in expressing a clinical phenotype that is likewise treated with a more complex therapeutic regime than that administered to those experiencing symptoms of depression without mental pain.

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Transdiagnostic biomarker approaches to mental health disorders: Consideration of symptom complexity, comorbidity and context

Cited by 13 publications

References 86 publications

Developing symptom clusters: linking inflammatory biomarkers to depressive symptom profiles

Developing symptom clusters: linking inflammatory biomarkers to depressive symptom profiles

Narcissistic Personality and Its Relationship with Post-Traumatic Symptoms and Emotional Factors: Results of a Mediational Analysis Aimed at Personalizing Mental Health Treatment

High depression symptomatology and mental pain characterize suicidal psychiatric patients

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