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Current Psychiatry Reports
Published in: Current Psychiatry Reports 9/2013

01-09-2013 | Mood Disorders (SM Strakowski, Section Editor)

Is Depression Simply a Nonspecific Response to Brain Injury?

Authors: Stephen M. Strakowski, Caleb M. Adler, Melissa P. DelBello

Published in: Current Psychiatry Reports | Issue 9/2013

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Abstract

Depressive disorders are among the most common ailments affecting humankind and some of the world’s leading causes of medical disability. Despite being common, disabling and a major public health problem, the etiology of depression is unknown. Indeed, investigators have suggested that the causes of depression are multiple and multi-factorial. With these considerations in mind, in this article we examine the hypothesis that our inability to identify the causes of depressive disorders is because depression is a nonspecific epiphenomenon of brain injury or insult arising through multiple pathways.
Literature
1.
Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. National Comorbidity Survey Replication. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289:3095–105.PubMedCrossRef
2.
World Health Organization. The world health report 2002: reducing risks, promoting healthy life. Geneva: World Health Organization; 2002.
3.
•• American Psychiatric Association. Diagnostic and statistical manual of mental disorders (Fifth ed.). Arlington: American Psychiatric; 2013. The DSM-5 alters a number of features about psychiatric diagnoses, namely by removing the 3-axis system, which might be particularly relevant to this article, since medical and psychiatric diagnoses are now treated similarly.
4.
World Health Organisation. ICD-10 classifications of mental and behavioural disorder: clinical descriptions and diagnostic guidelines. Geneva: World Health Organisation; 1992.
5.
Malone KM, Oquendo MA, Haas GL, Ellis SP, Li S, Mann JJ. Protective factors against suicidal acts in major depression: reasons for living. Am J Psychiatry. 2000;157:1084–8.PubMedCrossRef
6.
Weissman MM, Bruce ML, Leaf PJ, Florio LP, Holzer C. Affective disorders. In: Robins LN, Regier DA, editors. Psychiatric disorders in America: the epidemiologic catchment area study. NY: The Free Press; 1991. p. 53–80.
7.
Li C, Ford ES, Guixiang Z, Tsai J, Balluz LS. A comparison of depression prevalence estimates measured by the Patient Health Questionnaire with two administration modes: computer-assisted telephone interviewing versus computer-assisted personal interviewing. Int J Public Health. 2012;57:225–33.PubMedCrossRef
8.
Wight RG, Sepulveda JE, Aneshensel CS. Depressive symptoms: how do adolescents compare with adults. J Adolesc Health. 2004;34:314–23.PubMed
9.
• Regier DA, Narrow WE, Clarke DE, Kraemer HC, Kuramoto SJ, Kuhl EA, et al. DSM-5 field trials in the United States and Canada, Part II: test-retest reliability of selected categorical diagnoses. Am J Psychiatry. 2013;170:59–70. This and its companion papers demonstrate the ongoing difficulty psychiatry has developing reliable diagnostic criteria sets in the setting of field trials. However, in more structured research environments, reliability tends to be quite a bit higher for most conditions.PubMedCrossRef
10.
• Narrow WE, Clarke DE, Kuramoto SJ, Kraemer HC, Kupfer DJ, Greiner L, et al. DSM-5 field trials in the United States and Canada, Part III: development and reliability testing of a cross-cutting symptom assessment for DSM-5. Am J Psychiatry. 2013;170:71–82. This and its companion papers demonstrate the ongoing difficulty psychiatry has developing reliable diagnostic criteria sets in the setting of field trials. However, in more structured research environments, reliability tends to be quite a bit higher for most conditions.PubMedCrossRef
11.
Regier DA, Kaelber CT, Roper MT, Rae DS, Sartorius N. The ICD-10 clinical field trial for mental and behavioral disorders: results in Canada and the United States. Am J Psychiatry. 1994;151:1340–50.PubMed
12.
Keller MB, Klein DN, Hirschfeld RM, Kocsis JH, McCullough JP, Miller I, et al. Results of the DSM-IV mood disorders field trial. Am J Psychiatry. 1995;152:843–9.PubMed
13.
Goodwin FK, Jamison KR. Manic-depressive illness: bipolar disorders and recurrent depression. NY, NY: Oxford University Press, Inc; 2007. pp.13-15.
14.
Buckley PF, Miller BJ, Lehrer DS, Castle DJ. Psychiatric comorbidities and schizophrenia. Schizophr Bull. 2009;35:383–402.PubMedCrossRef
15.
Karno M, Golding JM. Obsessive compulsive disorder. In: Robins LN, Regier DA, editors. Psychiatric disorders in America: the epidemiologic catchment area study. NY: The Free Press; 1991. p. 204–19.
16.
Kessler RC, Stang PE, Wittchen HU, Ustun TB, Roy-Burne PP, Walters EE. Lifetime panic-depression comorbidity in the National Comorbidity Survey. Arch Gen Psychiatry. 1998;55:801–8.PubMedCrossRef
17.
Judd LL, Kessler RC, Paulus MP, Zeller PV, Wittchen HU, Kunovac JL. Comorbidity as a fundamental feature of generalized anxiety disorders: results from the National Comorbidity Study (NCS). Acta Psychiatr Scand Suppl. 1998;393:6–11.PubMedCrossRef
18.
Breslau N, Davis GC, Andreski P, Peterson E. Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry. 1991;48:216–22.PubMedCrossRef
19.
Klassen LJ, Katzman MA, Chokka P. Adult ADHD and its comorbidities, with a focus on bipolar disorder. J Affect Disord. 2010;124:1–8.PubMedCrossRef
20.
Schuckit MA. Comorbidity between substance use disorders and psychiatric conditions. Addiction. 2006;101 Suppl 1:76–88.PubMedCrossRef
21.
Conway KP, Compton W, Stinson FS, Grant BF. Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006;67:247–57.PubMedCrossRef
22.
Lenzenweger M, Lane M, Loranger A, Kessler RC. Personality disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;62:553–64.PubMedCrossRef
23.
Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2008;69:533–45.PubMedCrossRef
24.
Ayerbe L, Ayis S, Wolfe CD, Rudd AG. Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry. 2013;202:14–21.PubMedCrossRef
25.
Strober LB, Arnett PA. Assessment of depression in three medically ill, elderly populations: Alzheimer's disease, Parkinson's disease, and stroke. Clin Neuropsychol. 2009;23:205–30.PubMedCrossRef
26.
Barry JJ, Ettinger AB, Friel P, Gilliam FG, Harden CL, Hermann B, et al. Advisory group of the epilepsy foundation as part of its mood disorder. Consensus statement: the evaluation and treatment of people with epilepsy and affective disorders. Epilepsy Behav. 2008;13 Suppl 1:S1–29.PubMedCrossRef
27.
Reijnders JS, Ehrt U, Weber WE, Aarsland D, Leentjens AF. A systematic review of prevalence studies of depression in Parkinson's disease. Mov Disord. 2008;23:183–9.PubMedCrossRef
28.
Modrego PJ. Depression in Alzheimer's disease: pathophysiology, diagnosis, and treatment. J Alzheimers Dis. 2010;21:1077–87.PubMed
29.
Siegert RJ, Abernethy DA. Depression in multiple sclerosis: a review. J Neurol Neurosurg Psychiatry. 2005;76(4):469–75.PubMedCrossRef
30.
Buse DC, Silberstein SD, Manack AN, Papapetropoulos S, Lipton RB. Psychiatric comorbidities of episodic and chronic migraine. J Neurol. 2012 Nov 7. [Epub ahead of print].
31.
Huffman JC, Celano CM, Beach SR, Motiwala SR, Januzzi JL. Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovasc Psychiatry Neurol. 2013. doi:10.​1155/​2013/​695925.PubMed
32.
Norwood R. Prevalence and impact of depression in chronic obstructive pulmonary disease patients. Curr Opin Pulm Med. 2006;12:113–7.PubMedCrossRef
33.
Kimmel PL, Cukor D, Cohen SD, Peterson RA. Depression in end-stage renal disease patients: a critical review. Adv Chronic Kidney Dis. 2007;14:328–34.PubMedCrossRef
34.
Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12:160–74.PubMedCrossRef
35.
Joyce AT, Smith P, Khandker R, Melin JM, Singh A. Hidden cost of rheumatoid arthritis (RA): estimating cost of comorbid cardiovascular disease and depression among patients with RA. J Rheumatol. 2009;36:743–52.PubMedCrossRef
36.
Roy T, Lloyd CE. Epidemiology of depression and diabetes: a systematic review. J Affect Disord. 2012;142(Suppl):S8–21.PubMedCrossRef
37.
Kendler KS, Kessler RC, Walters EE, MacLean CJ, Neale MC, Heath AC, et al. Stressful life events, genetic liability, and onset of an episode of major depression in women. Am J Psychiatry. 1995;152:833–42.PubMed
38.
Gillespie NA, Whitfield JB, Williams B, Heath AC, Martin NG. The relationship between stressful life events, the serotonin transporter (5-HTTLPR) genotype and major depression. Psychol Med. 2005;35:101–11.PubMedCrossRef
39.
Sullivan PF, Neale MC, Kendler KS. Genetic epidemiology of major depression: review and meta-analysis. Am J Psychiatry. 2000;157:1552–62.PubMedCrossRef
40.
Foley DL, Neale MC, Kendler KS. Reliability of a lifetime history of major depression: implications for heritability and comorbidity. Psychol Med. 1998;28:857–70.PubMedCrossRef
41.
Bosker FJ, Hartman CA, Nolte IM, Prins BP, Terpstra P, Posthuma D, et al. Poor replication of candidate genes for major depressive disorder using genome-wide association data. Molec Psychiatry. 2011;16:516–32.CrossRef
42.
Saha S, Stedman TJ, Scott JG, McGrath JJ. The co-occurrence of common mental and physical disorders within Australian families: a national population-based study. Aust N Z J Psychiatry. 2013; Apr 29. [Epub ahead of print].
43.
Smoller JW, Finn CT. Family, twin, and adoption studies of bipolar disorder. Am J Med Genet C. 2003;123C:48–58.CrossRef
44.
McGuffin P, Rijsdijk F, Andrew M, Sham P, Katz R, Cardno A. The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Arch Gen Psychiatry. 2003;60:497–502.PubMedCrossRef
45.
Nestadt G, Samuels J, Riddle MA, Liang KY, Bienvenu OJ, Hoehn-Saric R, et al. The relationship between obsessive-compulsive disorder and anxiety and affective disorders: results from the Johns Hopkins OCD Family Study. Psychol Med. 2001;31:481–7.PubMedCrossRef
46.
Arabia G, Grossardt BR, Geda YE, Carlin JM, Bower JH, Ahlskog JE, et al. Increased risk of depressive and anxiety disorders in relatives of patients with Parkinson disease. Arch Gen Psychiatry. 2007;64:1385–92.PubMedCrossRef
47.
Merikangas KR, Merikangas JR, Angst J. Headache syndromes and psychiatric disorders: association and familial transmission. J Psychiatr Res. 1993;27:197–210.PubMedCrossRef
48.
Flory JD, Yehuda R, Passarelli V, Siever LJ. Joint effect of childhood abuse and family history of major depressive disorder on rates of PTSD in people with personality disorders. Depress Res Treat. 2012. doi:10.​1155/​2012/​350461.PubMed
49.
Zanarini MC, Vujanovic AA, Parachini EA, Boulanger JL, Frankenburg FR, Hennen J. Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. J Pers Disord. 2003;17:233–42.PubMedCrossRef
50.•
Price JL, Drevets WC. Neural circuits underlying the pathophysiology of mood disorders. Trends Cogn Sci. 2012;16:61–71. This article is a very well-written review of the functional neuroanatomy of human emotions and mood conditions.PubMedCrossRef
51.
• Strakowski SM. Integration and consolidation: a neurophysiological model of bipolar disorder. In: Strakowski SM, editor. The bipolar brain: integrating neuroimaging and genetics. NY: Oxford University Press, Inc.; 2012. This chapter is one in a text dedicated to integrating neuroimaging and genetics in bipolar disorder. The book provides a very comprehensive review from a number of the world’s leading experts in the study of bipolar disorder.CrossRef
52.
Sacher J, Neumann J, Funfstuck T, Soliman A, Villringer A, Schroeter ML. Mapping the depressed brain: a meta-analysis of structural and functional alterations in major depressive disorder. J Aff Dis. 2012;140:142–8.
53.
Koenigs M, Grafman J. The functional neuroanatomy of depression: distinct roles for ventromedial and dorsolateral prefrontal cortex. Behav Brain Res. 2009;201:239–43.PubMedCrossRef
54.
• McGrath CL, Kelley ME, Holtzheimer PE, Dunlop BW, Craighead WE, Franco AR, et al. Toward a neuroimaging treatment selection biomarker for major depressive disorder. JAMA Psychiatry. 2013;12:1–9. This article is a well-done idea paper to challenge the study of and treatment development for depression.
55.
Sudhyadhom A, Bova FJ, Foote KD, Rosado CA, Kirsch-Darrow L, Okun MS. Limbic, associative, and motor territories within the targets for deep brain stimulation: potential clinical implications. Curr Neurol Neurosci Rep. 2007;7:278–89.PubMedCrossRef
56.
Goghari VM, Sponheim SR, MacDonald 3rd AW. The functional neuroanatomy of symptom dimensions in schizophrenia: a qualitative and quantitative review of a persistent question. Neurosci Biobehav Rev. 2010;34:468–86.PubMedCrossRef
57.
Saxena S, Rauch SL. Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. Psychiatr Clin N Am. 2000;23:563–86.CrossRef
58.
Andreescu C, Aizenstein H. MRI studies in late-life mood disorders. Curr Top Behav Neurosci. 2012;11:269–87.PubMedCrossRef
59.
Liberzon I, Sripada CS. The functional neuroanatomy of PTSD: a critical review. Prog Brain Res. 2008;167:151–69.PubMedCrossRef
60.
Mauchnik J, Schmahl C. The latest neuroimaging findings in borderline personality disorder. Curr Psychiatry Rep. 2010;12:46–55.PubMedCrossRef
61.
Massart R, Mongeau R, Lanfumey L. Beyond the monoaminergic hypothesis: neuroplasticity and epigenetic changes in a transgenic mouse model of depression. Philos Trans R Soc Lond B Biol Sci. 2012;367:2485–94.PubMedCrossRef
62.
Forgeard MJ, Haigh EAP, Beck AT, Davidson RJ, Henn FA, Maier SF, et al. Beyond depression: toward a process-based approach to research, diagnosis, and treatment. Clin Psychol. 2011;18:275–99.
63.
Alladin A. The power of belief and expectancy in understanding and management of depression. Am J Clin Hypn. 2012;55:249–71.CrossRef
64.
Nieuwsma JA, Trivedi RB, McDuffie J, Kronish I, Benjamin D, Williams JW. Brief psychotherapy for depression: a systematic review and meta-analysis. Int J Psychiatry Med. 2012;43:129–51.PubMedCrossRef
65.
Artigas F, Nutt DJ, Shelton R. Mechanism of action of antidepressants. Psychopharmacol Bull. 2002;36 Suppl 2:123–32.PubMed
66.
67.
Preskorn SH. Declining differences in response rates with antidepressants versus placebo: a modest proposal for another contributing cause. J Psychiatr Pract. 2013;19:227–33.PubMedCrossRef
68.
Iovieno N, Papakostas GI. Correlation between different levels of placebo response rate and clinical trial outcome in major depressive disorder: a meta-analysis. J Clin Psychiatry. 2012;73:1300–6.PubMedCrossRef
69.
Andrade C. There’s more to placebo-related improvement than the placebo effect alone. J Clin Psychiatry. 2012;73:1322–5.PubMedCrossRef
70.
71.
72.
• Krystal JH, Sanacora G, Duman RS. Rapid-acting glutamatergic antidepressants: the path to ketamine and beyond. Biol Psychiatry. 2013;73:1133–41. This article present a review of novel potential antidepressants based on glutamatergic neurotransmission; as noted in the current article, novel approaches are sorely needed.PubMedCrossRef
73.
Pilc A, Wieronska JM, Skolnick P. Glutamate-based antidepressants: preclinical psychopharmacology. Biol Psychiatry. 2013;73:1125–32.PubMedCrossRef
74.
Bunney BG, Bunney WE. Mechanisms of rapid antidepressant effects of sleep deprivation therapy; clock genes and circadian rhythms. Biol Psychiatry. 2013;73:1164–71.PubMedCrossRef
Metadata
Title
Is Depression Simply a Nonspecific Response to Brain Injury?
Authors
Stephen M. Strakowski
Caleb M. Adler
Melissa P. DelBello
Publication date
01-09-2013
Publisher
Springer US
Published in
Current Psychiatry Reports / Issue 9/2013
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-013-0386-z

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