Abstract
(Reprinted from Transl Psychiatry. 2019 Apr 3; 9(1):127. Open access; is licensed under a Creative Commons Attribution 4.0 International License).
Highlights
Treatment outcomes for major depressive disorder (MDD) need to be improved
BDNF brain-derived neurotrophic factor, C-reactive protein (CRP) c-reactive protein, EEG electroencephalography, IL-6 interleukin-6, OCD obsessive-compulsive disorder, Positron emission tomography (PET) positron emission tomography, PTSD post-traumatic stress disorder, rsfMRI resting-state functional MRI, SLC6A4 solute carrier family 6 member 4, sMRI structural MRI, TNFa tumor necrosis factor alpha, TSPO translocator protein, 5-HT1A serotonin-1A receptor, MAO-A monoamine oxidase A, SERT serotonin transporter a Representative examples with meta-analytic evidence remission during treatment [35]
The research reviewed above indicates that early recognition and early adequate treatment at illness onset are preferable to watch-and-wait strategies
Summary
Treatment outcomes for major depressive disorder (MDD) need to be improved. This literature review sought to investigate factors closely linked to outcome and summarize existing and novel strategies for improvement. Potential biomarkers have been explored, including hippocampal volumes, neuronal activity of the anterior cingulate cortex, and levels of brain-derived neurotrophic factor (BDNF) and central and peripheral inflammatory markers (e.g., translocator protein (TSPO), interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor alpha (TNFa)) Their integration into routine clinical care has not yet been fully elucidated, and more research is needed in this regard. This review sought to: [1] provide a synopsis of key factors associated with outcomes in MDD, and [2] synthesize the existing literature on novel treatment strategies for depression. We defined ‘outcomes’ loosely, as either disease course (i.e., treatment resistance, chronic depression) or response/remission to treatment
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