Immunometabolic depression: Ready for personalized medicine?. (September 2021)

• Record Type: Journal Article
• Authors: Penninx, B.W.J.H.
• Is Part Of: Psychoneuroendocrinology. Volume 131(2021)Supplement
• Publication Date: 2021-09
• Subjects: Psychoneuroendocrinology -- Periodicals; Endocrinology -- Periodicals; Neurology -- Periodicals; Psychiatry -- Periodicals; Neuropsychoendocrinologie -- Périodiques; 616.8
• DOI: 10.1016/j.psyneuen.2021.105557
• Languages: English
• ISSNs: 0306-4530

Abstract

Abstract : The burden on society by depression is undisputable. This large burden is partly due to a course pattern that is more chronic than often assumed, and treatments that do not lead to remission in all patients. Precision psychiatry is aimed towards finding more specifically which pathophysiological mechanisms are underlying depression, and how this could inform treatment strategies. Heterogeneity in symptom patterns and pathophysiology deserves thereby explicit attention. Research that addresses precision psychiatry requires large-scale patient samples and detailed neurobiological and clinical characterization. The Netherlands Study of Depression and Anxiety (NESDA, www.nesda.nl) has followed >3000 adults over 9 years. Using NESDA data, Penninx's research group has consistently found that immuno-metabolic dysregulations vary as a function of depression heterogeneity: dysregulations map more consistently to "atypical" neurovegetative symptoms reflecting altered energy intake/expenditure balance (hyperphagia, weight gain, hypersomnia, fatigue and leaden paralysis). Treatment studies further suggest that the presence of immuno-metabolic dysregulations in depressed persons may moderate antidepressant effects of standard or novel (immunomodulatory) interventions. Penninx will describe how a immuno-metabolic depression dimension could dissect depression's heterogeneity and potentially match depressed subgroups to treatments with higher likelihood of clinical success.