Abstract
Background: Major depressive disorder (MDD) has different clinical presentations and is associated with neurobiological alterations. Hopelessness, anhedonia, and dissociation represent some of the most pervasive psychopathological symptoms that often lead to suicidal thoughts, attempts, and actions. To further research on the concept of depression endophenotypes, this study aimed to assess the possible relationships between hopelessness and other clinical and biological correlates (i.e., striatal dopaminergic dysfunction) in depressed patients. Methods: We recruited 51 subjects with MDD. All subjects underwent 123I-FP-CIT SPECT to assess striatal dopamine transporter (DAT) availability and a psychometric evaluation using the psychometric scale to assess depressive, anxious, dissociative, and hopelessness symptoms aside from suicidal ideation. Result: An inverse correlation between the hopelessness score and dopamine transporter availability in all basal ganglia was bilaterally found. (Right Putamen, r = −0.445, p < 0.01; Left Putamen, r = −0.454, p < 0.01; Right Caudate, r = −0.398, p < 0.01; Left Caudate, r = −0.467, p < 0.01) Moreover, a positive correlation was also found between hopelessness and dissociative symptoms. Conclusions: These results provide important evidence on the neurobiological and clinical correlates of different psychopathological symptoms of depression with potential implications in terms of devising more effective treatment programs.
Highlights
Major depressive disorder (MDD) is a high-burden disease characterized by several psychopathological dimensions, including mood deflection, suicidality, psychomotor retardation or agitation, loss of motivation, hopelessness and anhedonia [1]
Considering the common psychopathological aspects shared by anhedonia and hopelessness, such as the loss of motivation and negative beliefs, which seem to involve the dopaminergic reward system, the main aim of this study was to assess whether hopelessness is related to a peculiar striatal dopaminergic dysfunction in a sample of depressed patients; in addition, we assess suicidality through the use of a single item of Hamilton Depression Rating Scale, in order to evaluate a possible correlation between suicide risk and dopamine transporter (DAT) availability
Our results show the existence of an inverse correlation between hopelessness and DAT availability, which appears to have widely decreased in all basal ganglia
Summary
Major depressive disorder (MDD) is a high-burden disease characterized by several psychopathological dimensions, including mood deflection, suicidality, psychomotor retardation or agitation, loss of motivation, hopelessness and anhedonia [1]. Hopelessness has emerged as one of the core features of MDD [2]. It could be defined as a dimension characterized by negative expectancies for the future, lack of general motivation, and the attribution of wrong meanings to personal experiences [3]. Hopelessness, anhedonia, and dissociation represent some of the most pervasive psychopathological symptoms that often lead to suicidal thoughts, attempts, and actions. All subjects underwent 123 I-FP-CIT SPECT to assess striatal dopamine transporter (DAT) availability and a psychometric evaluation using the psychometric scale to assess depressive, anxious, dissociative, and hopelessness symptoms aside from suicidal ideation. Result: An inverse correlation between the hopelessness score and dopamine transporter availability in all basal ganglia was bilaterally found
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