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Major depressive disorder: a possible typisation according to serotonin, inflammation, and metabolic syndrome

Published online by Cambridge University Press:  10 September 2021

Ante Silić ,
Jakša Vukojević Open the ORCID record for Jakša Vukojević [Opens in a new window] ,
Vjekoslav Peitl ,
Marc De Hert  and
Dalibor Karlović
Ante Silić
Affiliation:
Department of Psychiatry, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia School of Medicine, Catholic University of Croatia, Zagreb, Croatia
Jakša Vukojević
Affiliation:
Department of pharmacology, University of Zagreb, Zagreb, Croatia
Vjekoslav Peitl*
Affiliation:
Department of Psychiatry, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia School of Medicine, Catholic University of Croatia, Zagreb, Croatia
Marc De Hert
Affiliation:
University Psychiatric Centre, KU Leuven, Leuven, Belgium Department of neurosciences, Clinical Psychiatry, KU Leuven, Leuven, Belgium AHLEC, Antwerp University, Antwerp, Belgium
Dalibor Karlović
Affiliation:
Department of Psychiatry, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia School of Medicine, Catholic University of Croatia, Zagreb, Croatia
*
Author for correspondence: Vjekoslav Peitl, Email: [email protected]
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Abstract

Objective:

Major depressive disorder (MDD) is closely related to obesity, inflammation, and insulin resistance, all together being etiologically linked to metabolic syndrome (MetS) development. The depressive disorder has a neuroendocrinological component, co-influencing the MetS, while MetS is characterised by increased cytokine levels, which are known to cause a depressed mood. This study aimed to establish biological subtypes of the depressive disorder based on researched clinical, laboratory, and anthropometric variables.

Methods:

We performed a cross-sectional study on a sample of 293 subjects (145 suffering from a depressive disorder and 148 healthy controls). Results were analysed with multivariate statistical methods as well as with cluster and discriminant analysis. In order to classify depressive disorder on the grounds of laboratory, anthropometric, and clinical parameters, we performed cluster analysis, which resulted in three clusters.

Results:

The first cluster is characterised by low platelet serotonin, high cortisol levels, high blood glucose levels, high triglycerides levels, high Hamilton Depression Rating Scale score, high waist circumference, high C-Reactive Protein values, and a high number of previous depressive episodes, was named Combined (Metabolic) depression. The inflammatory depression cluster is defined with average platelet serotonin values, normal cortisol, and all other parameter levels, except for increased IL-6 levels. The serotoninergic depression cluster is characterised by markedly low platelet serotonin, and all other parameters are within the normal range.

Conclusions:

From a biological point of view, depressive disorder is not uniform, and as such, these findings suggest potential clinically useful and generalisable biological subtypes of depressive disorder.

Keywords

MDDdepressionmetabolic syndromeserotonininflammation
Type
Original Article
Information
Acta Neuropsychiatrica , Volume 34 , Issue 1 , February 2022 , pp. 15 - 23
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Scandinavian College of Neuropsychopharmacology

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