Abstract
Major depressive disorder (MDD) has been hypothesized to lead to impairments in empathy. Previous cross-sectional studies did not disentangle effects of MDD itself and antidepressant treatment. In this first longitudinal neuroimaging study on empathy in depression, 29 patients with MDD participated in two functional magnetic resonance imaging (fMRI) sessions before and after 3 months of antidepressant therapy. We compared their responses to an empathy for pain task to a group of healthy controls (N = 35). All participants provided self-report ratings targeting cognitive (perspective taking) and affective (unpleasant affect) aspects of empathy. To control for general effects on processing of negative affective states, participants additionally underwent an electrical pain task. Before treatment, we found no differences in empathic responses between controls and patients with MDD. After treatment, patients showed significant decreases in both affective empathy and activity of three a priori selected brain regions associated with empathy for pain. Decreases in affective empathy were moreover correlated with symptom improvement. Moreover, functional connectivity during the empathy task between areas associated with affective (anterior insula) and cognitive (precuneus) empathy decreased between sessions in the MDD group. Neither cognitive empathy nor responses to painful electrical shocks were changed after treatment. These findings contradict previous cross-sectional reports of empathy deficits in acute MDD. Rather, they suggest that antidepressant treatment reduces the aversive responses triggered by exposure to the suffering of others. Importantly, this cannot be explained by a general blunting of negative affect, as treatment did not change self-experienced pain.
Highlights
Depression, one of the most widespread causes of disability of our time[1], substantially impairs social functioning in various ways[2]
By measuring an untreated sample at baseline and follow-up after 3 months of antidepressant therapy, we aimed to disentangle the effects of Major depressive disorder (MDD) and antidepressant treatment on empathy
By controlling for neural responses in an electrical pain task, we are able to draw conclusions regarding the specificity of the observed effects for empathy versus affective responding to aversive stimuli in general
Summary
Depression, one of the most widespread causes of disability of our time[1], substantially impairs social functioning in various ways[2]. While the impact of major depressive disorder (MDD) on mood and basic emotional processing has been investigated intensely Analysis3), few attempts have been made to explore its influence on empathy, which is a crucial skill for everyday social interactions. Empathy entails isomorphic sharing of another person’s affective state, which can be elicited by either direct observation or imagination of the target’s emotion[4] (see review for other definitions[5]). Evidence on the associations between depression and different behavioral and self-report measures of empathy has been reviewed by Schreiter et al.[6]. Most importantly, the included studies were conducted on very heterogeneous
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
