Dear Colleagues,
It is my pleasure to welcome you to the seventh issue of the year 2011 which focuses on Depression.
Christian Scharinger and Austrian colleagues present a review article on neuroimaging intermediate phenotypes of major depressive disorder (MDD) and their relation to genetic risk variants. The findings show that intermediate phenotypes may bridge the gap between genotype and phenotype by reducing the impreciseness of psychiatric phenotypes and yield more insights into the underlying biology.
Berthold Langguth and German colleagues present a review article on the interplay between tinnitus and depression. Neuroimaging studies confirm the existence of neural circuits that are activated both in depression and tinnitus, but these parallels in the pathophysiology of tinnitus and depression argue against comorbidity by chance and against depression as pure reaction on tinnitus. Instead, they stand for a complex interplay between tinnitus and depression. Implications for tinnitus treatment are discussed.
Alessandro Serretti and Italian colleagues evaluated the benefit of pharmacogenetics in antidepressant treatment. The trial includes 100,000 patients in a current episode of major depressive disorder (MDD), who received citalopram or bupropion based on the clinician's decision (algorithm A) or following indications from 5-HTTLPR genetic testing (algorithm B), which effect size of was estimated from a meta-analysis of pharmacogenetic trials. The findings indicate that it is favourable to incorporate pharmacogenetic testing in antidepressant treatment.
Deep brain stimulation (DBS) to the nucleus accumbens (NAcc-DBS) has antidepressant effects in patients suffering from treatment-resistant depression (TRD). However, limited information exists regarding the impact of NAcc-DBS on cognitive functioning. Christine Grubert and colleages examined whether NAcc-DBS in patients with TRD has any cognitive effects. The results not only support the cognitive safety of NAcc-DBS but also stress its beneficial role in augmenting cognitive performance in patients with TRD.
Sexual dysfunction (SD) is a frequently reported side-effect of antidepressant treatment, particularly of selective serotonin reuptake inhibitors (SSRIs). Jana Strohmaier and colleagues present a multicentre clinical and pharmacogenetic genome-based therapeutic drugs for depression (GENDEP) study in which they investigated the effect of the serotonin transporter gene promoter polymorphism 5-HTTLPR on sexual function during treatment with escitalopram (SSRI) and nortriptyline (tricyclic antidepressant). The study included 494 subjects, and rates of reported SD during treatment were lower than those described in previous reports. There was no apparent side effect of 5-HTTLPR on the observed decline in SD.
Luise Terroni and colleagues present an original investigation, for which 68 patients with first-ever ischaemic stroke and no history of major depressive disorder (MDD) were enrolled. Neurological and psychiatric examinations were performed at three time-points. The authors diagnosed MDD, following DSM-IV criteria. Lesion location and volume were determined with magnetic resonance imaging, using a semi-automated method based on the Brodmann Cytoarchitectonic Atlas. The findings indicate that MDD due to stroke is aetiologically related to the disruption of the left limbic-cortical-striatal-pallidal-thalamic (LCSPT) circuit and support the relevance of medial prefrontal cortex dysfunction in the pathophysiology of MDD.
Mental health and cardiovascular disease have been associated, whereas the temporal course and underlying mechanisms are still incompletely understood. Andrie Seldenrijk and colleagues from The Netherlands examined the presence of subclinical atherosclerosis in subjects with depressive or anxiety disorder, also taking into account disorder characteristics (subtype, severity, duration, age of onset, medication). The study included 470 depression or anxiety cases and 179 controls. The results suggest a distinct pathophysiology of late-onset as compared with early-onset depression, including a vascular component.