Abstract
Objective‘Treatment-resistant depression’ is depression that does not respond to an adequate regimen of evidence-based treatment. Treatment-resistant depression frequently becomes chronic. Children with treatment-resistant depression might also develop bipolar disorder (BD). The objective of this study was to determine whether serum levels of oxytocin (OXT) in treatment-resistant depression in adolescents (TRDIA) differ from non-treatment-resistant depression in adolescents (non-TRDIA) or controls. We also investigated the relationships between serum OXT levels and the clinical symptoms, severity, and familial histories of adolescent depressive patients.MethodsWe measured serum OXT levels: TRDIA (n = 10), non-TRDIA (n = 27), and age- and sex- matched, neurotypical controls (n = 25). Patients were evaluated using the Children’s Depression Rating Scale-Revised (CDRS-R) and the Depression Self-Rating Scale for Children-Japanese Version (DSRS-C-J). The patients were also assessed retrospectively using the following variables: familial history of major depressive disorder and BD (1st degree or 2nd degree), history of disruptive mood dysregulation disorder, recurrent depressive disorder (RDD), history of antidepressant activation.ResultsSerum levels of OXT among the TRDIA and non-TRDIA patients and controls differed significantly. Interestingly, the rates of a family history of BD (1st or 2nd degree), RDD and a history of antidepressant activation in our TRDIA group were significantly higher than those of the non-TRDIA group.ConclusionsSerum levels of OXT may play a role in the pathophysiology of TRDIA.
Highlights
Major depressive disorder in children and adolescents is characterized by one or more major depressive episodes, defined as at least 2 weeks of persistent change in mood manifested by either a depressed or irritable mood or a loss of interest or pleasure and at least four additional symptoms of depression [1,2]
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Serum levels of OXT may play a role in the pathophysiology of treatment resistant depression in adolescents (TRDIA)
Summary
Major depressive disorder in children and adolescents is characterized by one or more major depressive episodes, defined as at least 2 weeks of persistent change in mood manifested by either a depressed or irritable mood or a loss of interest or pleasure and at least four additional symptoms of depression [1,2]. Depression in children has been reported to be a recurrent and impairing condition associated with increased psychosocial and medical morbidity and mortality [3]. ‘Treatment-resistant depression’ is depression that does not respond to an adequate regimen of evidence-based treatment [4]. It is reported that ‘Treatment-resistant depression’ is up to a 50% reduction in depressive symptoms that follows 8–12 weeks of adequate evidencebased treatment [4]. Evidence-based treatments for adolescent depression are selective serotonin reuptake inhibitors (SSRIs), cognitive behavior therapy (CBT), and interpersonal therapy (IPT) [4,5,6]. 40% of depressed adolescent depressive patients who receive evidence-based treatments do not reach remission, so their group is called ‘treatment resistant depression in adolescents (TRDIA)’ [4,7,8]. One way to combat this disorder would be to discover novel biomarkers for it [10]
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