👤 Min Jhon

This study examined whether baseline levels of 14 serum biomarkers predicted antidepressant remission differently by sex at 12 weeks and 12 months. In a prospective cohort, 1,086 outpatients with depressive disorders received stepwise antidepressant treatment following a naturalistic protocol. Baseline serum samples were analyzed for biomarkers from six systems: immune (high-sensitivity C-reactive protein, tumor necrosis factor-alpha, interleukin-1 beta, interleukin-6, interleukin-4, interleukin-10), metabolic (leptin, ghrelin, total cholesterol), neurotrophic (brain-derived neurotrophic factor), neurotransmitter (serotonin), endocrine (cortisol), and nutritional (folate, homocysteine). Remission, defined as a Hamilton Depression Rating Scale scores ≤ 7, was assessed at 12 weeks and 12 months. Logistic regression models with biomarker-by-sex interaction and stratified analyses were used, adjusting for clinical covariates. Higher baseline serotonin predicted 12-week remission in males but not in females. At 12 months, lower leptin and higher folate predicted remission only in males, while lower cortisol predicted remission only in females. These showed significant biomarker-sex interactions. No sex-specific interactions were found for immune markers. Baseline serum biomarkers across biological systems showed sex-specific associations with treatment outcomes. Neurotransmitter, metabolic, endocrine, and nutritional markers may offer predictive value for sex-tailored, biomarker-informed treatment strategies in depression. Show less

This study investigated whether employment status moderates associations between baseline serum biomarkers and antidepressant remission at 12 weeks and 12 months. A prospective cohort of 1086 outpatients diagnosed with depressive disorders received stepwise antidepressant therapy using a naturalistic, flexible treatment protocol. Fourteen serum biomarkers covering immune (hsCRP, TNF-α, IL-1β, IL-6, IL-4, IL-10), metabolic (leptin, ghrelin, total cholesterol), neuroplastic (BDNF), neurotransmitter (serotonin), endocrine (cortisol), and nutritional (folate, homocysteine) domains were analyzed at baseline. Employment-dependent biomarker associations with remission (Hamilton Depression Rating Scale ≤7) at 12 weeks and 12 months were evaluated using logistic regression with biomarker-by-employment interactions and stratified analyses, adjusting for relevant covariates. Higher serotonin levels significantly predicted 12-week remission exclusively among employed patients, with a significant employment interaction. At 12 months, lower leptin levels predicted remission specifically in employed patients, whereas lower TNF-α and higher BDNF levels predicted remission only in unemployed patients, each demonstrating significant employment interactions. Baseline serum biomarkers showed employment-dependent associations with antidepressant remission outcomes, highlighting serotonin's short-term relevance and leptin, TNF-α, and BDNF as longer-term indicators. Although exploratory, these findings suggest that integrating employment status with biomarker profiles may enhance clinical decision-making by identifying patients who are more or less likely to benefit from treatment across different phases of recovery. Replication in independent cohorts is needed to establish the clinical applicability of such employment-tailored, biomarker-informed strategies. Show less

This study aimed to determine whether a history of childhood abuse (CA) and baseline serum brain-derived neurotrophic factor (sBDNF) levels predict remission at 12 weeks and 12 months in patients with depressive disorders, and to examine potential interactions between these factors. A total of 1,086 patients with depressive disorders, participating in a naturalistic, stepwise antidepressant treatment study, were assessed at baseline. CA was evaluated using the Nemesis Childhood Trauma Interview, and sBDNF levels were measured. Remission was defined as a Hamilton Depression Rating Scale score of ≤ 7. Logistic regression analyses examined the independent and interactive effects of CA and sBDNF on remission outcomes, adjusting for relevant covariates. Low baseline sBDNF independently predicted poorer remission at 12 months (p = 0.045) but not at 12 weeks (p = 0.720). In adjusted analyses, CA alone did not significantly predict remission at either time point (all p > 0.05). However, patients who had both a CA history and low baseline sBDNF showed significantly lower remission rates at 12 weeks (p = 0.018) and 12 months (p = 0.009), indicating a significant interaction between these factors. These findings underscore the importance of integrating psychosocial and biological factors in personalized depression treatment. Routine screening for childhood trauma, combined with assessment of sBDNF levels, may help identify high-risk patients needing targeted interventions. Further prospective research is necessary to validate these findings. Show less