Dimitriadis, M.M. (Menelaos) (2017) Nature, nurture or both? The role of Brain Derived NeurotrophicFactor and Early Childhood StressTraumatization in late life depression. thesis, Medicine.
Full text available on request.Abstract
BACKGROUND: Brain Derived Neurotrophic Factor (BDNF) has often been proposed as an important element of the pathophysiological mechanism underlying depression, but to this day its role remains ambiguous. On the other hand, the role of Early Childhood Traumatization is known to be of detrimental value in influencing the course of depression. Given the stress responsive nature of BDNF, we hypothesised that BDNF predicts depression remission and that its effect is moderated by the presence of early childhood traumatization. METHODS: Our study sample was a subset of the Netherlands Study of Depression in Older persons (NESDO), a prospective cohort study. Speciffically, it consisted of 268 older persons with a diagnosis of depression 6 months before baseline, for which follow-up data (after two years) were also available. Depressive disorders were assessed with a structured psychiatric interview at baseline and at the two-year follow-up period(CIDI, v2.1). Logistic regression was performed (adjusted for relevant covariates) with remission of depression after two years as the dependent variable and baseline BDNF serum levels, childhood traumatization as the two independent predictor variables. RESULTS: The mean age of the subjects was 70.7 years, 65.6% of them were female, their mean BDNF level was 7.7 ng/ml and 80/268 (29.9%) of them were traumatised in their childhood. Contrary to our hypothesis, BDNF serum levels were not associated with remission of late-life depression, while the hypothesized moderator, i.e. early childhood traumatization, was. However, also no moderation of BDNF effect was found from the presence of trauma. Post-hoc analysis showed that, our findings were conditional to the use of SSRIs as indicated by a significant three-way interaction (BDNF by traumatization by SSRI usage) on two-year remission status (p=0.01). Stratified analyses showed that higher BDNF serum levels predicted remission in traumatized depressed patients without SSRI usage (OR=1.2) and in non-traumatized depressed patients who used SSRIs, BDNF might again predict depression remission (OR=1.2). CONCLUSION: BDNF seems to predict remission only among a specific subgroup of depressed older patients, defined by the presence/absence of childhood traumatization and SSRI usage. Nonetheless, as this conclusion is based on post-hoc analyses, replication in an independent sample is warranted.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Under Supervision of: and Oude Voshaar, Prof Dr Richard MD PhD and Brink, Dr Rob van den PhD and Academic centre of Psychiatry and University Medical Centre Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:55 |
| Last Modified: | 25 Jun 2020 10:55 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1613 |
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