Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-23T00:31:05.987Z Has data issue: false hasContentIssue false

Recurrence in major depressive disorder: a neurocognitive perspective

Published online by Cambridge University Press:  31 July 2007

O. J. Robinson
Affiliation:
Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK
B. J. Sahakian*
Affiliation:
Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK
*
*Address for correspondence: Professor B. J. Sahakian, University Department of Psychiatry, Box 189, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK. (Email: [email protected])

Abstract

Depressive disorders are amongst the leading causes of disability and mortality worldwide and, as such, it is predicted that by 2010 only cardio-ischaemic disorders will provide a greater burden. In addition to the sizable emotional, individual and social burden, depressive disorders cost an estimated US$83·1 billion per year in the United States alone. In spite of effective treatments, a large proportion of sufferers go on to experience recurrences. With successive recurrences, the likelihood of subsequent episodes increases. Despite this, research to date has tended to focus on first episodes or else has not distinguished between episodes. This editorial review highlights a number of differences between first and recurrent episodes which, in turn, recommend more longitudinal, recurrence-oriented, treatments. We also examine the findings from acute tryptophan depletion studies which, it is speculated, help to understand the differences between successive episodes. The overall aim, however, is to highlight the importance of recurrence in depression and to stimulate debate.

Type
Editorial Review
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Benkelfat, C., Ellenbogen, M. A., Dean, P., Palmour, R. M. & Young, S. N. (1994). Mood-lowering effect of tryptophan depletion. Enhanced susceptibility in young men at genetic risk for major affective disorders. Archives of General Psychiatry 51, 687697.CrossRefGoogle ScholarPubMed
Booij, L., Van der Does, W., Benkelfat, C., Bremner, D., Cowen, P. J., Fava, M., Gillin, C., Leyton, M., Moore, P., Smith, K. A. & Van der Kloot, W. A. (2002). Predictors of mood response to acute tryptophan depletion: a reanalysis. Neuropsychopharmacology 27, 852861.CrossRefGoogle ScholarPubMed
Bouhuys, A. L. & Sam, M. M. (2000). Lack of coordination of nonverbal behaviour between patients and interviewers as a potential risk factor to depression recurrence: vulnerability accumulation in depression. Journal of Affective Disorders 57, 189200.CrossRefGoogle ScholarPubMed
Caspi, A., Sugden, K., Moffitt, T. E., Taylor, A., Craig, I. W., Harrington, H., McClay, J., Mill, J., Martin, J., Braithwaite, A. & Poulton, R. (2003). Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 301, 386389.CrossRefGoogle ScholarPubMed
Damasio, A. R. (1996). The somatic marker hypothesis and the possible functions of the prefrontal cortex. Philosophical Transactions of the Royal Society of London, Series B: Biological Sciences 351, 14131420.Google ScholarPubMed
de Kloet, E. R., Joels, M. & Holsboer, F. (2005). Stress and the brain: from adaptation to disease. Nature Reviews Neuroscience 6, 463475.CrossRefGoogle ScholarPubMed
Dickinson, A. (1981). Conditioning and associative learning. British Medical Bulletin 37, 165168.CrossRefGoogle ScholarPubMed
Ellenbogen, M. A., Young, S. N., Dean, P., Palmour, R. M. & Benkelfat, C. (1996). Mood response to acute tryptophan depletion in healthy volunteers: sex differences and temporal stability. Neuropsychopharmacology 15, 465474.CrossRefGoogle ScholarPubMed
Fossati, P., Harvey, P.-O., Le Bastard, G., Ergis, A.-M., Jouvent, R. & Allilaire, J.-F. (2004). Verbal memory performance of patients with a first depressive episode and patients with unipolar and bipolar recurrent depression. Journal of Psychiatric Research 38, 137144.CrossRefGoogle ScholarPubMed
Kendler, K. S., Thornton, L. M. & Gardner, C. O. (2001). Genetic risk, number of previous depressive episodes, and stressful life events in predicting onset of major depression. American Journal of Psychiatry 158, 582586.CrossRefGoogle ScholarPubMed
Lewinsohn, P. M., Allen, N. B., Seeley, J. R. & Gotlib, I. H. (1999). First onset versus recurrence of depression: differential processes of psychosocial risk. Journal of Abnormal Psychology 108, 483489.CrossRefGoogle ScholarPubMed
Murphy, F. C., Smith, K. A., Cowen, P. J., Robbins, T. W. & Sahakian, B. J. (2002). The effects of tryptophan depletion on cognitive and affective processing in healthy volunteers. Psychopharmacology 163, 4253.CrossRefGoogle ScholarPubMed
Murray, C. & Lopez, A. (1996). The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Harvard University Press.Google Scholar
Nandrino, J.-L., Dodin, V., Martin, P. & Henniaux, M. (2004). Emotional information processing in first and recurrent major depressive episodes. Journal of Psychiatric Research 38, 475484.CrossRefGoogle ScholarPubMed
Nandrino, J.-L., Pezard, L., Poste, A., Reveillere, C. & Beaune, D. (2002). Autobiographical memory in major depression: a comparison between first-episode and recurrent patients. Psychopathology 35, 335340.CrossRefGoogle ScholarPubMed
O'Reardon, J. P., Chopra, M. P., Bergan, A., Gallop, R., DeRubeis, R. J. & Crits-Christoph, P. (2004). Response to tryptophan depletion in major depression treated with either cognitive therapy or selective serotonin reuptake inhibitor antidepressants. Biological Psychiatry 55, 957959.CrossRefGoogle ScholarPubMed
Phillips, L. H., Bull, R., Adams, E. & Fraser, L. (2002). Positive mood and executive function: evidence from stroop and fluency tasks. Emotion 2, 1222.CrossRefGoogle ScholarPubMed
Post, R. M. & Weiss, S. R. (1998). Sensitization and kindling phenomena in mood, anxiety, and obsessive-compulsive disorders: the role of serotonergic mechanisms in illness progression. Biological Psychiatry 44, 193206.CrossRefGoogle ScholarPubMed
Russo, S., Kema, I. P., Fokkema, M. R., Boon, J. C., Willemse, P. H. B., de Vries, E. G. E., den Boer, J. A. & Korf, J. (2003). Tryptophan as a link between psychopathology and somatic states. Psychosomatic Medicine 65, 665671.CrossRefGoogle ScholarPubMed
Schachter, S. & Singer, J. (1962). Cognitive, social, and physiological determinants of emotional state. Psychological Review 69, 379398.CrossRefGoogle ScholarPubMed
Segal, Z. V., Williams, J. M., Teasdale, J. D. & Gemar, M. (1996). A cognitive science perspective on kindling and episode sensitization in recurrent affective disorder. Psychological Medicine 26, 371380.CrossRefGoogle ScholarPubMed
Sher, L., Oquendo, M. A., Galfalvy, H. C., Cooper, T. B. & Mann, J. J. (2004). The number of previous depressive episodes is positively associated with cortisol response to fenfluramine administration. Annals of the New York Academy of Sciences 1032, 283286.CrossRefGoogle ScholarPubMed
Teasdale, J. D. & Dent, J. (1987). Cognitive vulnerability to depression: an investigation of two hypotheses. British Journal of Clinical Psychology 26, 113126.CrossRefGoogle ScholarPubMed
Thase, M. E., Kupfer, D. J., Buysse, D. J., Frank, E., Simons, A. D., McEachran, A. B., Rashid, K. F. & Grochocinski, V. J. (1995). Electroencephalographic sleep profiles in single-episode and recurrent unipolar forms of major depression: I. Comparison during acute depressive states. Biological Psychiatry 38, 506515.CrossRefGoogle ScholarPubMed
Weissenborn, R. & Duka, T. (2000). State-dependent effects of alcohol on explicit memory: the role of semantic associations. Psychopharmacology 149, 98106.CrossRefGoogle ScholarPubMed