Abstract
Leading biological hypotheses propose that biological changes may underlie major depressive disorder onset and relapse/recurrence. Here, we investigate if there is prospective evidence for biomarkers derived from leading theories. We focus on neuroimaging, gastrointestinal factors, immunology, neurotrophic factors, neurotransmitters, hormones, and oxidative stress. Searches were performed in Pubmed, Embase and PsychInfo for articles published up to 06/2019. References and citations of included articles were screened to identify additional articles. Inclusion criteria were having an MDD diagnosis as outcome, a biomarker as predictor, and prospective design search terms were formulated accordingly. PRISMA guidelines were applied. Meta-analyses were performed using a random effect model when three or more comparable studies were identified, using a random effect model. Our search resulted in 67,464 articles, of which 75 prospective articles were identified on: Neuroimaging (N = 24), Gastrointestinal factors (N = 1), Immunology (N = 8), Neurotrophic (N = 2), Neurotransmitters (N = 1), Hormones (N = 39), Oxidative stress (N = 1). Meta-analyses on brain volumes and immunology markers were not significant. Only cortisol (N = 19, OR = 1.294, p = 0.024) showed a predictive effect on onset/relapse/recurrence of MDD, but not on time until MDD onset/relapse/recurrence. However, this effect disappeared when studies including participants with a baseline clinical diagnosis were removed from the analyses. Other studies were too heterogeneous to compare. Thus, there is a lack of evidence for leading biological theories for onset and maintenance of depression. Only cortisol was identified as potential predictor for MDD, but results are influenced by the disease state. High-quality (prospective) studies on MDD are needed to disentangle the etiology and maintenance of MDD.
Original language | English |
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Pages (from-to) | 321-338 |
Number of pages | 18 |
Journal | Molecular Psychiatry |
Volume | 25 |
Issue number | 2 |
Early online date | 19 Nov 2019 |
DOIs | |
Publication status | Published - 1 Feb 2020 |
Externally published | Yes |
Bibliographical note
Funding Information:Funding Funding was partly received from the Netherlands Institute for Advanced Study in the Humanities and Social Sciences (NIAS), entitled “My Optimism Wears Heavy Boots: So much research, so few implications, towards ‘patient-proof’ empirical models and more effective interventions in mental health” (awarded to CB February–June 2017). This meta-analysis has been pre registered (PROSPERO 2017 CRD42017072990) and preliminary results were presented at the European congress of Psychology (2017 Amsterdam) and Society of Biological Psychiatry annual meeting (2018 New York). All authors have approved the content of the present form of the paper.
Publisher Copyright:
© 2019, The Author(s).