Stella W Y Chan1, Catherine J Harmer2, Ray Norbury2, Ursula O'Sullivan2, Guy M Goodwin2, Maria J Portella3. 1. Section of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh EH8 9AG, UK; University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK. Electronic address: stella.chan@ed.ac.uk. 2. University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK. 3. University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Spain.
Abstract
BACKGROUND: Reduced hippocampal volume has been associated with clinical depression. However, it remains unclear whether these changes are a biological vulnerability marker or a consequence of this disorder. METHODS AND RESULTS (STUDY 1): We first compared hippocampal volumes between (i) never-depressed individuals with elevated risk for depression by virtue of high neuroticism (ii) recovered depressed individuals with matched levels of neuroticism; and (iii) individuals with low neuroticism and no history of depression. We replicated the finding of reduced hippocampal volume in the recovered group; unexpectedly however, the never-depressed high-risk group showed an increase in volume. One hypothesis is that this group had a mean age above the typical onset age for depression; hence, these participants who have remained euthymic despite their personality risk might in fact possess some resilience. METHODS AND RESULTS (STUDY 2): A subsequent study was therefore carried out to compare hippocampal volume between high-neurotic vs. low-neurotic volunteers in a younger sample. No group difference was found. LIMITATIONS: The present findings are limited by a small sample size; the cross-sectional design precluded us from makineg definitive conclusions about causal effect. CONCLUSION: Our overall results suggest that reduced hippocampal volumes is a neural marker for the scar effect of depression, although this structural impairment could also be seen as a vulnerability marker for the development of future recurrent episodes. By contrast, larger hippocampal volumes could be a biological marker of resilience. These findings have clinical implications regarding treatment development for the prevention of illness onset and recurrent depressive episodes.
BACKGROUND: Reduced hippocampal volume has been associated with clinical depression. However, it remains unclear whether these changes are a biological vulnerability marker or a consequence of this disorder. METHODS AND RESULTS (STUDY 1): We first compared hippocampal volumes between (i) never-depressed individuals with elevated risk for depression by virtue of high neuroticism (ii) recovered depressed individuals with matched levels of neuroticism; and (iii) individuals with low neuroticism and no history of depression. We replicated the finding of reduced hippocampal volume in the recovered group; unexpectedly however, the never-depressed high-risk group showed an increase in volume. One hypothesis is that this group had a mean age above the typical onset age for depression; hence, these participants who have remained euthymic despite their personality risk might in fact possess some resilience. METHODS AND RESULTS (STUDY 2): A subsequent study was therefore carried out to compare hippocampal volume between high-neurotic vs. low-neurotic volunteers in a younger sample. No group difference was found. LIMITATIONS: The present findings are limited by a small sample size; the cross-sectional design precluded us from makineg definitive conclusions about causal effect. CONCLUSION: Our overall results suggest that reduced hippocampal volumes is a neural marker for the scar effect of depression, although this structural impairment could also be seen as a vulnerability marker for the development of future recurrent episodes. By contrast, larger hippocampal volumes could be a biological marker of resilience. These findings have clinical implications regarding treatment development for the prevention of illness onset and recurrent depressive episodes.
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