P-494 - Self-reference and emotion regulation in patients suffering from depression

Abstract

Introduction The study of self-referential brain activity may be of great importance in order to gain a better understanding about self-related symptoms at the psychopathological level in affective disorders. Objectives A previous investigation in healthy individuals showed that emotional introspection in comparison to cognitive self-reflection was associated with enhanced activation in prefrontal regions as well as reduced amygdalar activity. Hence, emotional introspection is in accordance with a mindfulness based treatment potentially reducing emotional arousal. Aims In the present study, this was also investigated in depressed patients. Methods 20 depressed patients performed either cognitive self-reflection (“who am I…”) or emotional introspection (“what do I feel..”),12 seconds each, while they were scanned with functional magnetic resonance imaging (fMRI). Results were compared with the data of 20 healthy individuals. Results In the comparison of emotional introspection versus self-reflection, depressed patients showed greater brain activity in prefrontal and parietal cortical midline areas, including cingulate cortex. While activation in the left amygdala was reduced during emotional introspection, it was enhanced during the self-reflection condition. In comparison with healthy individuals, patients showed pronounced brain activity in medial as well as dorsal prefrontal regions during introspection versus self-reflection. Conclusions By means of mindfulness like emotional introspection, depressed patients are able to down-regulate their amygdala, which is in support with mindfulness based cognitive strategies in psychotherapy. Nonetheless, increased prefrontal activation in depressed patients may indicate a greater need for resources.