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2020, Biological Psychiatry. DOI: 10.1016/j.biopsych.2020.01.012
Causes and Consequences of Diagnostic Heterogeneity in Depression: Paths to Discovering Novel Biological Depression Subtypes
Charles J. Lynch , Faith M. Gunning , Conor Liston
Abstract:
Depression is a highly heterogeneous syndrome that bears only modest correlations with its biological substrates, motivating a renewed interest in rethinking our approach to diagnosing depression for research purposes and new efforts to discover subtypes of depression anchored in biology. Here, we review the major causes of diagnostic heterogeneity in depression, with consideration of both clinical symptoms and behaviors (symptomatology and trajectory of depressive episodes) and biology (genetics and sexually dimorphic factors). Next, we discuss the promise of using data-driven strategies to discover novel subtypes of depression based on functional neuroimaging measures, including dimensional, categorical, and hybrid approaches to parsing diagnostic heterogeneity and understanding its biological basis. The merits of using resting-state functional magnetic resonance imaging functional connectivity techniques for subtyping are considered along with a set of technical challenges and potential solutions. We conclude by identifying promising future directions for defining neurobiologically informed depression subtypes and leveraging them in the future for predicting treatment outcomes and informing clinical decision making.
2022-12-31 18:17:00
#paper Causes and Consequences of Diagnostic Heterogeneity in Depression: Paths to Discovering Novel Biological Depression Subtypes https://doi.org/10.1016/j.biopsych.2020.01.012 抑郁症是一种高度异质性的综合症。 该综述文章回顾了抑郁症诊断异质性的主要原因。 并讨论使用数据驱动策略根据功能性神经影像学测量发现新的抑郁症亚型的前景,包括维度、分类和混合方法来解析诊断异质性和理解其生物学基础。 最后,文章考虑了使用静息态功能磁共振成像功能连接技术进行子类型化的优点以及一系列技术挑战和潜在解决方案。
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