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Cited by 31Treatment of Major DepressionStress Responses and CortisolTryptophan and brain disorders

Pathophysiology of Major Depression by Clinical Stages

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de Menezes Galvão, Ana Cecília, Almeida, Raíssa Nobrega, de Sousa, Geovan Menezes, Leocadio-Miguel, Mario André, Palhano-Fontes, Fernanda, de Araujo, Dráulio Barros, Lobão-Soares, Bruno, Maia-de-Oliveira, João Paulo +5 more·2021·Frontiers in Psychology
DOI 10.3389/fpsyg.2021.641779PMC PMC8374436
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Abstract

The comprehension of the pathophysiology of the major depressive disorder (MDD) is essential to the strengthening of precision psychiatry. In order to determine the relationship between the pathophysiology of the MDD and its clinical progression, analyzed by severity of the depressive symptoms and sleep quality, we conducted a study assessing different peripheral molecular biomarkers, including the levels of plasma C-reactive protein (CRP), serum mature brain-derived neurotrophic factor (mBDNF), serum cortisol (SC), and salivary cortisol awakening response (CAR), of patients with MDD ( n = 58) and a control group of healthy volunteers ( n = 62). Patients with the first episode of MDD ( n = 30) had significantly higher levels of CAR and SC than controls ( n = 32) and similar levels of mBDNF of controls. Patients with treatment-resistant depression (TRD, n = 28) presented significantly lower levels of SC and CAR, and higher levels of mBDNF and CRP than controls ( n = 30). An increased severity of depressive symptoms and worse sleep quality were correlated with levels low of SC and CAR, and with high levels of mBDNF. These results point out a strong relationship between the stages clinical of MDD and changes in a range of relevant biological markers. This can assist in the development of precision psychiatry and future research on the biological tests for depression.

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  • Existing TRD definitions fail to take into consideration the social, economic, anamnestic and interpersonal factors which, alone or in combinations, are known to moderate antidepressant response.

    “Further drawbacks of existing TRD defi­ nitions are that they fail to take into consid­ eration the social, economic, anamnestic (e.g., adverse childhood experiences) and interpersonal factors which, alone or in combinations, are known to moderate antidepressant response 1,44,47,71,75-­ 81 .”

    From Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions (2023) · cites this paper as [80]

    The Materials and Methods (Participants; page unavailable) define TRD by nonresponse to at least two antidepressant classes, without including the listed social or personal-history factors. The Results discuss income and other characteristics of the TRD group, but the paper does not establish that social, economic, anamnestic, or interpersonal factors moderate antidepressant response, nor does it explicitly critique existing TRD definitions on that basis. (LLM, conf=0.78)

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Authors
de Menezes Galvão, A. C., Almeida, R. N., de Sousa, G. M., Leocadio-Miguel, M. A., Palhano-Fontes, F., de Araujo, D. B., Lobão-Soares, B., Maia-de-Oliveira, J. P., Nunes, E. A., Hallak, J. E. C., Schuch, F. B., Sarris, J., & Galvão-Coelho, N. L.
Affiliations
  • Universidade Federal do Rio Grande do Norte (BR)
  • Universidade de São Paulo (BR)
  • Universidade Federal de Santa Maria (BR)
  • The University of Melbourne (AU)
ORCID
Venue
Frontiers in Psychology
Publisher
Frontiers Media SA
Published
2021-08-05
Volume
12
Pages
641779-641779
ISSN
1664-1078 (ISSN-L)
DOI
10.3389/fpsyg.2021.641779
PMC
PMC8374436
OpenAlex
W3190663505
Cited by
31
References
109
Citations by year
2026: 4 · 2025: 8 · 2024: 7 · 2023: 5 · 2022: 6 · 2021: 1
FWCI
2.77
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
Funders
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (#1677/2012, 88887, (Code 001), 1577/2013, 88887.466701/2019-00, APP1125000, 2019‐01, 88882.344060/2019-01, 88882)
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico (466760/2014, #479466/2013)
  • Ministério da Educação (APP1125000, 1577/2013, 1677/2012, 88887.466701/2019-00)
  • Universidade Federal do Rio Grande do Norte
  • National Health and Medical Research Council (88887.466701/2019-00, 1125000)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
Keywords
major depressive disorder, pathophysiology, clinical stage, treatment-resistant depression, first-episode depression, biomarkers, C-reactive protein, brain-derived neurotrophic factor, cortisol, cortisol awakening response, sleep quality, depression severity, precision psychiatry

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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