Abstract
Major Depression is a complex disorder with a growing incidence worldwide and multiple variables have been associated with its etiology. Nonetheless, its diagnosis is continually changing and the need to understand it from a multidimensional perspective is clear. The purpose of this study was to identify risk factors for depression in a case-control study with 100 depressive inpatients and 87 healthy controls. A multivariate logistic regression analysis was performed including psychosocial factors, cognitive maladaptive schema domains, and specific epigenetic marks (BDNF methylation levels at five CpG sites in promoter IV). A family history of depression, the cognitive schemas of impaired autonomy/performance, impaired limits, other-directedness, and the methylation level of a specific CpG site were identified as predictors. Interestingly, we found a mediating effect of those cognitive schemas in the relationship between childhood maltreatment and depression. Also, we found that depressive patients exhibited hypomethylation in a CpG site of BDNF promoter IV, which adds to the current discussion about the role of methylation in depression. We highlight that determining the methylation of a specific region of a single gene offers the possibility of accessing a highly informative an easily measurable variable, which represents benefits for diagnosis. Following complete replication and validation on larger samples, models like ours could be applicable as additional diagnostic tools in the clinical context.
Highlights
Major Depressive Disorder (MDD) is a highly prevalent and vastly complex clinical condition, which requires a multidimensional approach in its study [1,2,3,4]
A multifactorial logistic model was evaluated in the present study, including psychosocial, cognitive, and epigenetic factors associated with MDD
Regarding the family history of depression, recent evidence reports that familial risk increases the probability of individual lifetime depression [22, 46]
Summary
Major Depressive Disorder (MDD) is a highly prevalent and vastly complex clinical condition, which requires a multidimensional approach in its study [1,2,3,4]. Several studies have highlighted that the risk of suffering from depression is related to cognitive patterns acquired during childhood, shaping the individual’s ability to cope with daily life events during adulthood [5,6,7,8,9] In this regard, early environmental conditions, including maltreatment and a family history of depression, have been linked to the disorder [10, 11]. There is a well-established link between developing EMS and the impossibility of satisfying psychological needs, such as manifesting autonomy or secure attachment, which is related to parental care [12] For this point, there is evidence suggesting that individuals whose families have a history of depression are more likely to develop the disorder, given that they are exposed to adverse conditions created in the familiar context [22]
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